急性脑梗死患者血浆NT-proBNP临床意义  

Study on the Levels of N-terminal Pro-brain Natriuretic Peptide in Plasma in Patients with Acute cerebral infarction

作　　者：孔艳艳[1] 刘楠[2] 姜新[2] 陈晓虹[2] 

机构地区：[1]大连医科大学研究生院,辽宁大连116044 [2]辽宁省人民医院神经内科,沈阳110016

出　　处：《中国实用内科杂志》2013年第S1期114-117,共4页Chinese Journal of Practical Internal Medicine

基　　金：辽宁省医学高峰建设资助项目

摘　　要：目的探讨急性脑梗死患者血浆N端脑利纳肽前体(NT-proBNP)含量变化的意义。方法将发病48小时内的急性脑梗死患者作为研究对象,根据TOAST分型方法进行病因学分型,所有患者均于入院48小时内行NT-proBNP含量测定,分析NT-proBNP含量与脑梗死亚型的关系。结果 237例急性脑梗死患者中动脉粥样硬化性脑梗死(LAA)64例、小血管闭塞性脑梗死(SAO)60例、心源性脑栓塞(CE)54例和原因不明性脑梗死59例。其中CE组患者血浆NT-proBNP水平明显高于非CE组(P均<0.001),非CE组间差异不显著;入院时神经功能缺损严重者(美国国立卫生研究院卒中量表评分NIHSS≥7分),NT-proBNP水平显著高于入院时神经功能缺损轻微者(NIHSS评分<7分)(P<0.001);死亡患者NT-proBNP水平明显高于存活患者(P<0.001)。结论急性脑梗死尤其是CE患者血浆NT-proBNP水平显著升高,且神经功能缺损越严重,其水平越高;死亡患者NT-proBNP水平显著升高。脑梗死患者早期检测血浆NT-proBNP水平有助于脑梗死病因学亚型诊断,尤其是CE的诊断及有助于病情严重程度及预后的判断。Objective To investigate the Levels of N-terminal Pro-brain Natriuretic Peptide in Plasma in Patients with Acute cerebral infarction.Methods Patients with acute cerebral infarction enrolled within 48 hours of onset were divided according to the TOAST classification.Plasma NT-proBNP levels were measured in 48 hours after be hospitalized,and the correlation between plasma NT-proBNP levels and differrent subtypes of cerebral infarction were analyzed.Results 237 cases of acute cerebral infarction in patients with large-artery atheroscl-erosis 64 cases,small-artery occlusion 60 cases,cardioembolism54 cases and cryptog-enicc cerebral infarction 59 cases.The plasma NT-proBNP levels in the cardioembo-lism group were significantly higher than those in all the non-cardioembolism groups(all P<0.001),while there were no significant differences in plasma NT-proBNP levels among all the non-CE groups.Patients in serious condition(NIHSS ≥ 7),the NT-proB-NP value is significantly higher than the mild(NIHSS <7)(P<0.001).Conclusion Acute cerebral infarction,particularly the plasma NT-proBNP levels were increased significantly in patients with cardioembolism,the more serious the disease and the higher level.Early detection of plasma NT-proBNP level contribute to etiological classification of cerebral infarction,especially for the diagnosis of cardioembolism,the severity as well as the prognosis of the disease.

关 键 词：急性脑梗死 NT-PROBNP 

分 类 号：R743.33[医药卫生—神经病学与精神病学]