| Objective:1.To investigate the clinical value of creatine kinase MB(CK-MB),amino terminal pro brain natriuretic peptide(NT-proBNP)and high sensitive cardiac troponin T(hs-TnT)in the assessment of cardiac structural function in patients with end-stage renal disease(ESRD)undergoing maintenance dialysis。2.To compare the serum CK-MB,NT-proBNP,hs-TnT levels in hemodialysis and peritoneal dialysis patients,and to explore the predictive indexes of CVD in HD and PD patients,so as to provide theoretical basis for clinical selection of different dialysis methods.Methods:70 ESRD patients who met the inclusion criteria were recruited as ESRD group(hemodialysis:35;peritoneal dialysis:35),and 35 healthy volunteers were recruited as control group(CON).Collect the primary diseases of HD and PD patients,the basic information of all subjects,BMI,systolic blood pressure,diastolic blood pressure and other clinical data;collect the venous blood of subjects,and detect serum total cholesterol(TC),triglyceride(TG),creatine kinase isoenzyme MB(CK-MB),amino terminal pro brain natriuretic peptide(NT-proBNP),high-sensitivity troponin T(hs-TnT);and The subjects were examined by echocardiography,and the data of the two groups were analyzed by spss20.0 software.Results:1.The median level of hs-TnT in ESRD patients was 31.28 ng/L,IQR was 23.44ng/L,61 patients(87.14%)had abnormal high level of hs-TnT(≥14ng/L).the median level of CK-MB was 18.73 U/L,IQR was 17.46 U/L,4 patients(5.71%)had abnormal high level of CK-MB(≥25 U/L).the median level of NT-proBNP was 18.62 ng/ml,IQR was 17.33ng/ml,39 patients(55.71%)had abnormal high level of NT-proBNP(≥9.25ng/ml).2.The levels of hs-TnT,CK-MB and NT-proBNP in ESRD patients were positively correlated with age,dialysis age,hypertension and LVMI(P<0.05),and negatively correlated with LVEF(P<0.05).3.The serum hs-TnT,CK-MB,and NT-proBNP levels in ESRD patients were significantly higher than those in patients with no-LVH and no-LVDD.The ROC curve shows that hs-TnT has the highest accuracy in predicting left ventricular hypertrophy and left ventricular diastolic dysfunction compared to CK-MB and NT-proBNP.4.There was no significant difference in serum CK-MB level(t=1.037,P=0.091>0.05)and abnormal proportion(?~2=0.000,P=1.000>0.05)between hemodialysis and peritoneal dialysis patients,while NT-proBNP level in hemodialysis patients was significantly higher than that in peritoneal dialysis patients(t=2.086,P=0.034<0.05),but there was no significant difference in abnormal proportion(?~2=2.837,P=0.920>0.05).5.The mean level of hs-TnT in hemodialysis patients was 38.51±12.49ng/l,the median was 35.74ng/l,the IQR was 28.45ng/L;the mean level of hs-TnT in peritoneal dialysis patients was 26.24±10.03ng/l,the median was 24.12ng/L,the IQR was 23.51ng/L,which was significantly lower than that in hemodialysis patients(t=2.15,P=0.032<0.05).6.There were 34 patients(97.14%)with hs-TnT≥14ng/L in hemodialysis patients and 27 patients(77.14%)with hs-TnT≥14ng/L in peritoneal dialysis patients,the difference was statistically significant(?~2=6.24,P=0.012<0.05).Conclusion:1.The levels of serum CK-MB,NT-proBNP and hs-TnT in ESRD patients undergoing maintenance dialysis have a certain clinical value for the evaluation of cardiac structure and function,and the predictive value of serum hs-TnT level on cardiac structure dysfunction in ESRD patients is better than CK-MB and NT-proBNP.Hs-TnT is a laboratory index for monitoring cardiovascular events in ESRD patients.2.Compared with hemodialysis patients,the level of hs-TnT in peritoneal dialysis patients is lower.Hs-TnT has a good predictive value of CVD,which has a certain reference significance for clinical choice of dialysis treatment. |
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