射血分数轻度降低型心力衰竭中医证型与理化指标及预后的相关性研究OA

Objective To explore the distribution characteristics of traditional Chinese medicine(TCM)syndrome types in patients with heart failure with mildly reduced ejection fraction(HFmrEF)and their correlation with related physicochemical indicators and prognosis.Methods Clinical data of 200 HFmrEF patients admitted to the Department of Cardiology of Maoming Hospital of Guangzhou University of Chinese Medicine(Maoming Hospital of Traditional Chinese Medicine)from June 2023 to December 2024 were collected.General data,underlying diseases,New York Heart Association(NYHA)functional classification,TCM syndrome types,physicochemical indicators[hemoglobin(Hb),serum creatinine(SCr),N-terminal pro-B-type natriuretic peptide(NT-proBNP)]and the occurrence of cardiovascular(CV)events as follow-up endpoints were recorded.SPSS 27.0 software was used for statistical analysis to explore the correlation between TCM syndrome types and various clinical data in HFmrEF patients.Logistic regression analysis was used to screen risk factors affecting patient prognosis,and receiver operating characteristic(ROC)curve analysis was used to explore the predictive value of related factors.Results(1)Among 200 HFmrEF patients,there were 109 males(54.50%)and 91 females(45.50%).The TCM syndrome types in descending order of frequency were:qi deficiency and blood stasis syndrome in 81 cases(40.50%),yang qi deficiency and blood stasis syndrome in 71 cases(35.50%),and qi-yin deficiency and blood stasis syndrome in 48 cases(24.00%).(2)Characteristics of each syndrome type:patients with qi deficiency and blood stasis syndrome were significantly younger than those with qi-yin deficiency and blood stasis syndrome and yang qi deficiency and blood stasis syndrome,with statistically significant differences(P＜0.05);patients with yang qi deficiency and blood stasis syndrome had the highest proportion of concurrent phlegm-fluid retention syndrome,proportion of NYHA class Ⅳ,proportion of CV events and NT-proBNP level,with statistically significant differences(P＜0.05);patients with qi-yin deficiency and blood stasis syndrome had the lowest Hb level and highest SCr level,with statistically significant differences(P＜0.05);there were statistically significant differences in the proportions of complicated coronary heart disease,valvular disease,diabetes and cerebral infarction among patients with different syndrome types(P＜0.05 or P＜0.01).(3)Multivariate Logistic regression analysis showed that phlegm-fluid retention syndrome,diabetes and SCr were independent risk factors for CV events within 1 year in HFmrEF patients,all with certain predictive value(P＜0.001).ROC curve analysis showed that the combined predictive efficacy of the above three indicators for CV events was superior to that of any single indicator,with an area under the curve(AUC)of 0.791[95%CI(0.718,0.864),P＜0.001],a sensitivity of 75.0%and a specificity of 76.5%.Conclusion The distribution of TCM syndrome types in HFmrEF is significantly correlated with cardiac function classification,physicochemical indicators and underlying comorbidities,and yang qi deficiency and blood stasis syndrome represents a more severe condition.Phlegm-fluid retention syndrome,diabetes and SCr are important indicators affecting the prognosis of HFmrEF,which can provide reference for the diagnosis,treatment and prognosis evaluation of HFmrEF.