血浆和肽素水平对急性脑梗死患者预后的评估价值  

Evaluative value of plasma copeptin level on prognosis in patients with acute cerebral infarction

作　　者：李俊[1] 张爱梅[2] 李宪章[2] 吕秋杰[1] 

机构地区：[1]天津医科大学研究生院,300070 [2]济宁医学院附属医院神经内科

出　　处：《临床神经病学杂志》2011年第6期411-414,共4页Journal of Clinical Neurology

摘　　要：目的探讨血浆和肽素水平对急性脑梗死患者预后的评估价值。方法对60例急性脑梗死患者(急性脑梗死组)和60例健康体检者(正常对照组)进行血浆和肽素水平检测;并对急性脑梗死患者进行血压、血糖、血清超敏C反应蛋白(hs-CRP)水平检测,应用美国国立卫生研究院卒中量表(NIHSS)进行评分,应用MRI测量脑梗死体积,3个月后采用改良的Rankin量表(mRS)评分评价预后;分析血浆和肽素水平对急性脑梗死患者预后的影响。结果急性脑梗死组血浆和肽素水平[(3.73±0.49)ng/ml]明显高于正常对照组[(2.85±0.24)ng/ml](P<0.01);脑梗死预后不良亚组(42例)[(3.84±0.44)ng/ml]明显高于预后良好亚组(18例)[(3.47±0.53)ng/ml](P<0.05);两亚组间年龄、血糖、血清hs-CPR水平、NIHSS评分、脑梗死体积的差异有统计学意义(P<0.05～0.01);单因素Logistic回归分析显示,血浆和肽素水平、年龄、NIHSS评分是影响急性脑梗死患者预后的因素(P<0.05～0.01)。ROC分析显示,影响急性脑梗死患者预后的因素中,血浆和肽素水平与年龄、hs-CRP水平、脑梗死体积、NIHSS评分间差异无统计学意义。结论血浆和肽素水平升高是预测急性脑梗死患者预后不良的因素之一。Objective To investigate evaluative value of the plasma copeptin level on prognosis in patients with acute cerebral infarction （ACI）. Methods The plasma copeptin level were measured in 60 ACI patients （ACI group） and 60 normal controls （NC group）. In ACI group, the blood pressure, the levels of glucose, and high- sensitive C-reactive protein （hs-CRP） were measured; score of the National Institutes of Health Stroke Scale （NIHSS） were assessed; the volume of infarct was measured using MRI. Three months later the prognosis of them were assessed by the modified Rankin Scale （mRS）. The influence of plasma copeptin level on the prognosis of ACI patients were analyzed. Results The lever of plasma copepti＇n in ACI group [ （ 3. 73 ±0. 49 ） ng/ml ] was significantly higher than control group [ （2.85 ±0.24） ng/ml] （ P 〈 0. 01 ） ; and which in prognosismala subgroup [ 42 cases, （3.47± 0.53 ） ng/ml] was significantly higher than prognosisbona subgroup[ 18 cases, （ 3.84 ± 0.44 ） ng/ml] （ P 〈 0. 05 ）. Between the two subgroups, the differences of age, levels of glucose, hs-CPR, scores of NIHSS and volumes of infarct were statistically significance（ P 〈 0. 05 - 0.01 ）. Univariate logistic regression analysis showed that the plasma copeptin level, age and NIHSS score were the influecnc factors of prognosis in ACI patients （P 〈0. 05- 0.01 ）. Receiver operating characteristic （ROC） analysis demonstrated that there were no statistical diffrence among those influence factors such as the levels plasma copeptin, glucose, hs-CRP, value of infarct, scores of NIHSS on prognosis. Conclusion Increased plasma copeptin level is one of the prodictors of prognosismala in ACI patients.

关 键 词：和肽素 急性脑梗死 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]