Study On NT-proBNP Levels And Its Influencing Factors In Hematologic Disease Patients Associated With Anemia

Objective:To investigate the relationship between hematologic diseases patients with anemia and NT-proBNP and its influencing factorsMethods: A retrospective study was conducted on 137 patients diagnosed with hematologic diseases and anemia in the 967 th Hospital of the Chinese People’s Liberation Army From March 2011 to August 2020.According to whether NT-proBNP≥300 ng/L or not,they were divided into two groups,NT-proBNP normal group(NNG)and NT-proBNP increased group(NIG),which were the NT-proBNP were < 300ng/L and ≥300ng/L,respectively.Age,sex,Body Mass Index and NT-proBNP、WBC、RBC、Hb、HCT、MCV、MCH、MCHC、RDW、PLT、TBIL、DBIL、TBIL、ALT、AST、Scr、BUN、eGFR were used as observation indexes to carry out the study.Results:1.Among 137 hematological diseases patients associated with anemia,the NT-proBNP of 113 patients was increased at admission,accounting for 82.5%,the median NT-proBNP was significantly higher than NNG,which were 2496.17ng/L and160.61ng/L,respectively,with statistical significance between the two groups(P<0.01).2.Among 137 different hematological diseases patients associated with anemia,the increase of NT-proBNP was most common in hematologic malignancies(HM)patients,with an incidence of 94.7%,idiopathic thrombocytopenic purpura(ITP)was the lowest,63.6%,without statistical significance among all groups(P>0.05).In the NNG,the median NT-proBNP of 113 hematologic patients associated with anemia was 2496.17(300.00～30000.00)ng/L,and the media NT-proBNP was the highest in the patients with HM,and the lowest in ITP patients,which were 4403.26ng/L and 1900.00ng/L,respectively,but there was no statistical significance between the groups(P>0.05).3.Among patients with different degrees of anemia,the median NT-proBNP of severe anemia patients was the highest,followed by patients with moderate anemia,and patients with mild anemia were the lowest,which were 2300.00 ng/L、1800.00 and816.29 ng/L,respectively;The differences among mild anemia group moderate anemia group and severe anemia group were statistically significant(P<0.05),while that between moderate anemia group and severe anemia group was not statistically significant(P>0.05).4.In the NT-proBNP increase of hematopathy patients associated with anemia,the average Hb at discharge was higher than that at admission,and the difference between the two groups was statistically significant(P<0.01);the median NT-proBNP at discharge was significantly lower than before admission,and the difference between the two groups was statistically significant(P<0.01).After further analysis,it was found that for each 1.0g/L increase in Hb,the mean decrease of the median NT-proBNP was about 431.97ng/L.5.Among 137 hematological diseases patients associated with anemia,the median RBC、Hb、HCT in the NNG and NIG were lower than the normal reference value,the median RBC、Hb and HCT levels in the NIG were lower than those in NNG,and the difference between the two groups was statistically significant(P<0.05);Spearman rank correlation analysis showed that NT-proBNP was correlated with RBC、Hb、HCT(R values were-0.304,-0.256,-0.289,respectively,P<0.01);The median MCV、MCH levels in the NNG and NIG were within the normal reference range,the median MCV and MCH levels in the NIG were higher than those in NNG,without statistical significant difference in median MCV and MCH levels between the two groups(P>0.05);The median RDW levels in NNG and NIG were higher than the normal reference value,the median RDW levels in the NIG was slightly lower than in the NNG.Without statistical significant difference in median RDW levels between NT-proBNP increased group and normal group(P>0.05).6.Among 137 hematological diseases patients associated with anemia,the median TBIL、DBIL、IBIL、ALT and AST levels in the NNG and NIG were within the normal reference range,the median TBIL、DBIL、IBIL、ALT and AST levels in the NIG were higher than in the NNG,among which with statistical significant in the median of TBIL and DBIL between the two groups(P<0.05),without statistical significant in the other indexes between the two groups(P>0.05).The median Scr and BUN levels in the NNG and NIG were within the range of normal reference,the median Scr in the NIG were higher than in the NNG,but the median BUN in the NIG was slightly lower than in the NNG,without statistical significant between the two groups(P>0.05).The average eGFR in the NNG was within the range of normal reference,the average eGFR in the NIG was lower than the normal reference value,and the average eGFR in the NIG was significantly lower than in the NNG,without statistical significant between the two groups(P<0.05).Conclusion:1.The proportion of patients with elevated NT-proBNP level is higher among the patients with hematologic diseases associated with anemia.2.In patients with different common hematologic diseases associated with anemia,the proportion with NT-proBNP≥300 ng/L is higher than 60%,show a certain regularity.3.With the decrease of RBC、Hb and HCT,the NT-proBNP levels in hematologic diseases patients with anemia increased,and they show negative correlation;The improvement of anemia is helpful to the decrease of NT-proBNP.4.TBIL、DBIL and eGFR levels is correlated with the NT-proBNP level in hematologic diseases patients associated with anemia.