|
|
|
| Correlation analysis between distribution features of tongue manifestations and some risk factors of the heart failure in dialysis patients |
| WANG Xiaolan1 XIAO Yonghua1 REN Chuanyun1 CAO Po1 LIU Yongguo2 YANG Shuming2 YIN Di1 ZHONG Jian1 |
1.Department of Nephrology and Endocrinology, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 100700, China;
2.Chinese Medicine Knowledge and Data Engineering Laboratory, Information and Software Engineering College, University of Electronic Science and Technology of China, Sichuan Province, Chengdu 610054, China |
|
|
|
Abstract Objective To investigate the correlation between the distribution of tongue image in patients with maintenance hemodialysis and some indices of the heart failure. Methods From August 2016 to April 2017, 77 cases of MHD patients (≥3 months) from Dongzhimen Hospital of Beijing University of Chinese Medicine and the First Integrated Traditional Chinese and Western Medicine Hospital were collected tongue information uniformly with the portable tongue image instrument. The tongue image was imported into the computer software "TCM expert system of tongue diagnosis". Three experts who are over deputy director of the physician level quantitated the 16 parameters of tongue image including the tongue spirit, the tongue color, the tongue shape, the teeth marks, cracks and etc to analyze MHD patients' distribution features of tongue manifestations; at the same time, the blood samples were took on the first day of tongue shooting, including blood routine, renal function, ion detection, serum albumin, BNP before hemodialysis, and the urea clearance index (Kt/V), the rate of urea decline (URR), the rate of interdialysis weight growth were calculated, then the correlation between tongue manifestations and objective indices was analyzed and the rules from it was found. Results Among the 77 patients undergoing maintenance hemodialysis, 41 cases were male and 36 cases were female. The score of teeth-marked tongue was positively associated with the rate of interdialysis weight growth (r = 0.488). The score of purple tongue, dark tongue, ecchymosis and thick coating were positively associated with BNP, which was positively correlated with congestion tongue (the value of r was in turn 0.532, 0.491, 0.525, 0.332, all P ＜ 0.01). Conclusion There is a positive correlation between the teeth-marked tongue and the rate of interdialysis weight growth in the maintenance hemodialysis patients. The congestion tongue is positively associated with the serum BNP. So the congestion tongue with teeth marks can be used as a reference for the hemodialysis patients with potential heart failure.
|
|
|
|
|
|
[1] 张国锋，唐国文，曾盛.血液透析发生慢性并发症的原因分析及防治[J].现代医药卫生，2012，28（5）：668-670.
[2] Staffeld CG，Pastan SO. Cardiac disease in patients with end-stage renal disease [J]. Cardiology clinics，1995，13（2）：209-223.
[3] 王海燕，王梅.慢性肾脏病及透析的临床实践指南[M].北京：人民卫生出版社，2003：13-14.
[4] 张昱，翁维良，刘刚，等.慢性肾衰竭维持性血液透析患者瘀血舌与血清hs-CRP相关性的研究[J].中国中医基础医学杂志，2010，16（10）：897-898.
[5] 张昱.慢性肾衰竭维持性血液透析患者瘀血舌与血清hs-CRP相关性的研究[C]//第六次全国中西医结合养生学与康复医学学术研讨会论文集.中国中西医结合养生学与康复医学专业委员会，2009：7.
[6] 赵洁，赵战云.透析间期体重增长率与透析充分性的关系分析[J].中国临床新医学，2013，6（4）：332-334.
[7] 李松.抗凝剂在血液透析中的应用[J].中国实用医药，2012，7（2）：134-135.
[8] 黄燕杏，周惠芳，区美琼，等.预见性护理干预在预防维持性血液透析患者心衰发生的措施[J].国际医药卫生导报，2013，19（15）：2407-2409.
[9] Hambali Z，Ahmad Z，Arab S，et al. Oxidative stress and its association with cardiovascular disease in chronic renal failure patients [J]. Indian J Nephrol，2011，21（1）：21-25.
[10] 翟丽.实用血液净化技术及护理[M].北京：人民军医出版社，2012：157.
[11] 王霄一，卢国元.Ｂ型钠尿肽评估血液透析患者干体重的临床意义[J].中国血液流变学杂志，2007，17（1）：90-91.
[12] 张建荣，耿燕秋，张承英，等.干体重对血液透析患者血压和心功能的影响[J].武警医学，2011，22（12）：1017-1018，1023.
[13] 韦虎，漆波，王德荣等.B-型钠尿肽对诊断中国心衰患者的系统评价[J].西部医学，2010，22（6）：1046-1050.
[14] 骆金伟.心力衰竭诊断进展[C]//2009年钱江国际心血管病会议暨浙江省心血管病年会论文汇编.浙江省医学会心血管病学分会：浙江省科学技术协会，2009：4.
[15] 王妍.BNP与心力衰竭诊断的临床进展[J].中外医疗，2009，28（5）：154.
[16] Doust JA，Glasziou PP，Pietrzak E，et al. A systematic review of the diagnostic accuracy of natriuretic peptides for heart failure [J]. Archives of Internal Medicine，2004， 164（18）：1978-1984.
[17] Bertinchant JP，Combes N，Polge A，et al. Prognostic value of cardiac troponin T in patients with both acute and chronic stable congestive heart failure：comparison with atrial natriuretic peptide，brain natriuretic peptide and plasma norepinephrine [J]. Clinica Chimica Acta，2005， 352（1）：143-153.
[18] 中华医学会心血管病学分会，中华心血管病杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志，2007，35（12）：1076-1095.
[19] 耿旭，马宾.BNP及NT-proBNP和心肌缺血缺氧关系的研究进展[J].医学综述，2014，20（8）：1374-1376.
[20] 黄淑田，张丽娜，金露萍.慢性心力衰竭患者肾小球滤过率、血清脑钠肽与血尿酸水平变化及其相关性研究[J].中华临床医师杂志：电子版，2011，5（23）：7132-7135. |
|
|
|
