基于心肾代谢综合征探讨无症状期下肢动脉粥样硬化早期肾损伤与中医证素的相关性OA

[Objective]Based on the cardiovascular-kidney-metabolic(CKM)framework,this study aimed to explore the correlation between early renal injury and traditional Chinese medicine(TCM)syndrome elements in patients with asymptomatic lower extremity arterial atherosclerosis(LEAD).[Methods]A retrospective analysis was conducted on 216 asymptomatic LEAD patients,who were categorized into a normal microalbuminuria(MAU)group(MAU<30 mg/L,140 cases)and an abnormal MAU group(MAU≥30 mg/L,76 cases).The distribution of TCM syndrome elements was compared between groups.Spearman correlation and binary logistic regression were used to examine associations between syndrome elements and renal function indicators.[Results]The abnormal MAU group had significantly higher age,proportion of hypertension history,Crouse score,serum creatinine,and cystatin C,but lower ankle-brachial index(ABI)and estimated glomerular filtration rate(eGFR),P<0.05.The predominant TCM syndrome elements were phlegm-turbidity(50.0%),qi deficiency(47.7%),and blood stasis(43.5%).The proportion of phlegm-turbidity was significantly higher in the abnormal MAU group(61.8%)than in the normal group(43.6%,P<0.05).Logistic regression identified history of hypertension(OR=2.106),ABI(OR=0.153),and phlegm-turbidity(OR=2.043)as independent influencing factors for abnormal MAU(P<0.05).[Conclusion]Early renal injury in asymptomatic LEAD patients results from the synergistic effects of hypertension,vascular lesions,and metabolic disorders.The high prevalence of phlegm-turbidity syndrome element and its significant association with MAU abnormality suggest its core role in the"metabolic-vascular-renal"injury axis,providing a new perspective for integrated Chinese and Western medicine interventions.