Analysis On The Changes And Influencing Factors Of Hypersensitive Troponin ? In Non-Dialysis Patients With Chronic Kidney Disease

Objective: To investigate the influence factors of hs-cTnI level in non-dialysis patients with chronic kidney disease,so as to provide help for early screening and identification of people at risk of cardiovascular events in patients with chronic kidney disease.Methods: Single center retrospective study.A total of 256 patients diagnosed with CKD were selected from the 921 hospital of the people's liberation army from January 2018 to January 2019.The general information and laboratory indicators of the patients were recorded in detail.Each patient was examined by color doppler ultrasound,and the hs-cTnI level and related influencing factors were evaluated and analyzed by using relevant statistical methods.Results: 1.A total of 256 patients were collected,ranging in age from 20 to 89 years old,with an average age of 55.98±15.06 years old,among which 54.69%(140/256)were male,45.31%(116/256)were female,median hs-cTnI level was 0.013(0.007~0.035)ng/ml,and 73(28.52%)patients had elevated hs-c TnI level(> 0.034ng/ml).2.The proportion of patients with abnormal hs-cTnI in each stage of CKD was as follows: CKD1 stage 13.33%(2/15),CKD2 stage14.29%(3/21),CKD3 stage 21.43%(6/28),CKD4 stage 30.00%(15/50),CKD5 stage 33.10%(47/142).3.hs-cTnI levels in each stage were 0.004(0.001-0.007),CKD2stage:0.008(0.007~0.010)ng/ml,CKD3 stage 0.006(0.003~0.014)ng/ml,CKD4 stage 0.012(0.006~0.035)ng/ml,CKD5 stage 0.021(0.010~0.041)ng/ml.4.In the history of coronary heart disease,,systolic blood pressure,eGRF,CR,BUN,?2 microglobulin,PTH,P,HB,LVMI,and NT-proBNP of patients in the hs-cTnI elevated group and the hs-cTnI normal group,P< 0.05,indicating a significant difference between the two groups.5.256 research object,a total of 133 patients with diagnostic criteria,to the left ventricle hypertrophy using chi-square test for troponin and left ventricular hypertrophy group analysis,P < 0.05,there is statistical significance,troponin rises in normal group and the group have significant differences on left ventricular hypertrophy,elevated troponin group of left ventricular hypertrophy prevalence was 63.38%(45/71),higher than the normal troponin prealence of left ventricular hypertrophy was 47.57%(88/185).6.The results of multiple linear stepped-regression analysis showed that the history of coronary heart disease,HB,NT-proBNP,LVMI,P and PTH were the influencing factors of hs-cTnI.In the history of coronary heart disease in CKD patients without dialysis,HB was reduced,and the increase of P,PTH,NT-proBNP and LVMI could cause the increase ofhs-cTnI.Conclusions: 1.Elevated levels of hypersensitive troponin I were found in non-dialysis CKD patients without ACS.2.The history of coronary heart disease,anemia,elevation of NT-pro BNP,left ventricular hypertrophy,hyperparathyroidism and hyperphosphatemia in non-dialysis CKD patients will cause the increase of hs-c TnI.