Abstract:Objective:To retrospectively analyze the left ventricular ejection fraction (LVEF) in peritoneal dialysis (PD) patients with different Chinese medicine syndrome types,and evaluate the impact of dynamic changes in LVEF on the survival of PD patients with different syndrome types through a time-dependent model. Methods:Collected general information [gender,age,primary disease,body mass indes (BMI), comorbidity index (CCI)], laboratory indicators (all LVEF, pre dialysis uric acid, hemoglobin, erythrocyte sedimentation rate,high-sensitivity C-reactive protein,blood urea,blood creatinine,triglycerides,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,serum total protein, serum albumin,alkaline phosphatase,total bilirubin,etc.),and outcome events (occurrence time) of PD patients with different syndrome types. Used multiple factor Cox regression to screen for dependent variables that affect survival rate,and then incorporated these dependent variables into a time-dependent Cox regression model to further investigate the impact of dynamically changing LVEF on the prognosis of PD patients with different syndrome types. Results: The average dialysis age, average survival time, and gender comparison of PD patients with different syndrome types showed significant differences (P<0.05). The proportion of primary disease of the spleen kidney yang deficiency group as diabetes nephropathy was higher than that of the spleen kidney qi deficiency group and the deficiency of both yin and yang group (P= 0.022),and the proportion of primary disease as glomerular disease was lower than that of spleen kidney qi deficiency group and deficiency of both yin and yang group (P=0.047). The comorbidity index of the spleen kidney yang deficiency group was higher after excluding age (P=0.002). The spleen kidney yang deficiency group had lower left ventricular short axis shortening rate and LVEF, and higher total bilirubin at the beginning of dialysis, with significant difference (P<0.05). For all syndrome types of patients, the age, gender, and age adjusted CCI scores were independent risk factors for all-cause mortality in PD patients (P<0.05); the primary disease being glomerular disease, and high-density lipoprotein cholesterol were protective factors (P<0.05), and there was significant difference in spleen kidney qi deficiency syndrome (P<0.05). As the treatment progresses,for every 5% increase in LVEF,the all-cause mortality rate of PD patients was decreased by 8%;in PD patients with spleen kidney yang deficiency,for every 5% increase in LVEF,the all-cause mortality rate was decreased by 11%. Conclusion:PD patients mainly suffer from spleen kidney yang deficiency syndrome. There are differences in average dialysis age, average survival time,and gender among PD patients of different syndrome types. Improvement in LVEF has a protective effect on the prognosis of all syndrome types,and the protective effect is more significant in patients with spleen kidney yang deficiency.