The Diagnostic Value Of NT-proBNP And Hs-TnT In Chronic Kidney Disease Patients With Acute Heart Failure

Objective:To investigate the diagnostic value of N-terminal pro brain natriuretic peptide(NT-pro BNP)and high-sensitivity troponin T(hs-c Tn T)in chronic kidney disease stage 4(CKD4)patients with acute decompensated heart failure(ADHF).Methods:Fifty-two patients with CKD4 and ADHF(Group A),fifty-two patients with CKD4(Group B)and fifty-two patients with ADHF(Group C)were selected in Baoding NO.1 Central Hospital during December 2018 to December 2020.The age,sex,hight,wight,past history(hypertension,diabetes,dyslipidemia),personal history(smoking history,drinking history),systolic blood pressure(SBP)and diastolic blood pressure(DBP)of all subjects were collected,and body mass index(BMI)was calculated.Serum NT-pro BNP,hs-c Tn T and serum creatinine(Scr)in all subjects were determined,estimated Glomerular Filtration Rate(e GFR)was computed.Simultaneously,Left Atrium Dimension(LAD),Left Ventricular End Diastolic Dimension(LVEDD),Left Ventricular End Systolic Dimension(LVESD)and Left Ventricular Ejection Fraction(LVEF)were measured.Pearson correlation analysis and multiple linear regression analysis were used to analyze the relevant factors and independent influencing factors of serum NT-pro BNP and hs-c Tn T.The diagnostic value of the two indicators were analyzed by plotting the receiver operating characteristic curve(ROC).Results:1.Serum NT-pro BNP and hs-c Tn T levels among the three groups were significant differences(P<0.001).The two indicators in Group A were significantly higher than group B or group C(P < 0.05),there was no significant difference between group B and group C.2.Pearson correlation analysis showed that serum NT-pro BNP was positively correlated with LAD,LVESD and LVEDD(P<0.05),and negatively correlated with LVEF and e GFR(P<0.001).The serum hs-c Tn T was positively correlated with LVESD and LVEDD(P <0.05),and negatively correlated with LVEF and e GFR(P<0.001).Multiple linear regression analysis showed that LVEDD 、 LVEF and e GFR were independent influencing factors for Serum NT-pro BNP and hs-c Tn T levels(P <0.05).3.ROC analysis showed that the area under the curve of serum NT-pro BNP and hs-c Tn T were 0.896 and 0.972 respectively.The sensitivity of NT-pro BNP and hs-c Tn T in the diagnosis of ADHF in patients with CKD4 was 86.50% and 80.80%,the specificity was 96.20%and 92.30%,respectively,with 3456.5pg/ml、53.50pg/ml as the critical values(P < 0.05).Both of them provided assistance in the diagnosis of ADHF in patients with CKD4.Conclusion:NT-pro BNP and hs-c Tn T that reflect cardiac and renal function are comprehensive biochemical indexes.LVEDD,LVEF and e GFR are independent risk factors of NT-pro BNP and hs-c Tn T.As for CKD4 patients,increasing the cut-off values of NT-pro BNP and hs-c Tn T to3456.5pg/ml and 53.50pg/ml respectively can effectively improve the specificity of diagnosis of ADHF,and provide certain scientific basis for improving the clinical diagnosis rate.