| Objective : The changes of serum brain natriuretic peptide(BNP)and N-terminal B-type natriuretic placenta(NT-proBNP),hemoglobin and albumin in different CKD stages were detected in patients with chronic renal disease,and the significance of BNP and NT-proBNP in evaluating cardiac function was discussed by combining the ejection fraction((EF))representing systolic function and E / A value representing diastolic function by color Doppler echocardiography.And the influence of other factors on BNP and NT-proBNP index.Methods : A total of 82 patients with chronic kidney disease were selected from September 2019 to October 2020 in the Department of Nephrology,Department of Nephrology,Shengjing Hospital affiliated to China Medical University.The glomerular filtration rate was calculated according to the modified(MDRD)formula of dietary improvement test for kidney disease in China.according to the glomerular filtration rate,the experimental group was divided into CKD1 stage,CKD2 stage,CKD3 stage,CKD4 stage and CKD5 stage,and then divided into experimental group1,CKD1-2 group(n = 15),experimental group 2,CKD3-4 group(n = 22),and experimental group 3,namely CKD5 stage group(n = 30).Experimental group 4:regular dialysis group(n = 15).The control group was selected from 48 patients with cardiac neurosis diagnosed in the Department of Cardiovascular Medicine of Shengjing Hospital affiliated to China Medical University in the same period.The differences of BNP and NT-proBNP concentration,hemoglobin concentration and albumin concentration in different groups were compared.According to the value of E/ A > 1 and E / A > 1,the experimental group was divided into two groups: normal cardiac diastolic function and decreased cardiac diastolic function to compare the concentration difference of BNP and NT-proBNP,and to compare the concentration difference of BNP and NT-proBNP between the two groups according to the EF >55% and the EF > 55% of cardiac Doppler echocardiography,the two groups were divided into two groups: normal cardiac systolic function and decreased cardiac systolic function.The ROC curve was used to evaluate the AUC area and critical value of BNP and NT-proBNP in patients with chronic kidney disease when the EF value of cardiac color Doppler ultrasound was 55%.The correlation between BNP,NT-proBNP and EF in patients with chronic kidney disease was compared.Results : The levels of NT-proBNP and BNP in the experimental group were significantly higher than those in the control group,and the concentrations of NT-proBNP and BNP in the experimental group 1,2,3 and 4 increased gradually with the progress of renal insufficiency,and the EF levels in all experimental groups were lower than those in the control group.The EF levels in experimental groups 1,2,3and 4 were similar,but still decreased slowly with the progress of renal function.The levels of serum albumin and hemoglobin in the experimental group were lower than those in the control group.In the experimental group,the Pearson correlation between BNP and EF was-0.557,and the Pearson correlation between NT-proBNP and EF was-0.483(P < 0.01).Under the ROC curve,the NT-proBNP area of the experimental group was AUC=0.797,BNP,and the AUC= area of the experimental group was 0.852.The critical value of BNP for patients with chronic kidney disease was 237.45 pg for patients with chronic kidney disease and the cut-off value for patients with chronic kidney disease was 29955pg/ml.Conclusions : BNP and NT-proBNP still have significance in the diagnosis of decreased left ventricular ejection fraction in patients with chronic kidney disease,but in patients with chronic kidney disease,the correlation between BNP and EF is closer than that of NT-proBNP,and the sensitivity,authenticity and specificity of EF are stronger than that of NT-proBNP.BNP and NT-proBNP have no significance in the change of cardiac diastolic function in patients with chronic kidney disease.Renal insufficiency affected the levels of BNP and NT-proBNP,and with the development of renal insufficiency,the levels of BNP and NT-proBNP increased gradually,while the renal function from CKD1 to CKD4 had no significant effect on EF. |
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