入院时血浆脑利钠肽水平与急性缺血性脑卒中预后的关系探讨  

The relationship between plasma BNP level on admission and neural function recovery degree of the 3 months' phase in patients with Acute Ischemic Stroke

作　　者：刘团结[1] 方麒林[1] 丁联斌[1] 姜国林[1] 毛蕾[1] 沈滔[1] 王博[1] 钟玲[1] 刘恋[1] 

机构地区：[1]上海交通大学附属第一人民医院宝山分院神经内科,上海200940

出　　处：《上海预防医学》2012年第10期536-540,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市宝山区科委基金资助项目(10-E-20)

摘　　要：[目的]探讨急性缺血性脑卒中病人入院时血浆脑利钠肽(BNP)水平能否成为急性缺血性脑卒中病人发病后3个月神经功能恢复程度的预测指标。[方法]根据《中国急性缺血性脑卒中诊治指南2010》诊断标准,前瞻性入选88例24 h内发病的急性缺血性脑卒中病人,于入院24 h内检测血浆BNP,将3个月后神经功能恢复良好组与3个月后神经功能恢复较差组进行比较。[结果]发病3个月后神经功能恢复程度与入院时BNP值等级、梗死体积均有显著相关性(P值﹤0.001),3个月后神经功能恢复较差组入院时血浆BNP水平[(884.75±330.07)pg/mL]显著高于3个月后神经功能恢复良好组[(263.27±281.89)pg/mL],P<0.001。入院时血浆BNP水平≥366.40 pg/mL可作为发病3个月后神经功能恢复较差组的预测指标,其敏感性为96.00%,特异性为76.19%。[结论]急性缺血性脑卒中病人入院时血浆BNP水平可作为其发病3个月后神经功能恢复程度的预测因子。[ Objective] To estimate the predictor application of the plasma brain natriuretic peptide level in acute ischemic stroke patients by investigating the relationship between the brain natriuretic peptide level with neural function recovery degree of the 3 months ＇ phase. [ Methods ] According to the diagnostic criteria stipulated in the ＂Chinese acute ischemic stroke diagnosis and treatment guidelines 2010 ＂, we prospectively enrolled 88 patients with AIS within 24 hours of onset and measured the plasma brain natriuretic peptide, thus comparing the good recovery group and the bad recovery group. [ Results ] There was a significant correlation found between neural function recovery degree of the 3 months＇ phase and the plasma brain natriuretic peptide level, infarction volume in patients with acute ischemic stroke （ P 〈 0. 001 ）. The plasma brain natriuretic peptide levels on admission were significantly higher in the bad group than in the good group（ 884.75 ±330.07 pg/mL vs. 263.27±281.89pg/mL, P 〈0.001 ）. The predictor level, sensitivity and specificity of the plasma BNP level in bad neural function recovery of the 3 months＇ phase showed brain natriuretic peptide level of≥ 366.40pg/mL, 96.00 % and 76.19 %. [ Conclusion ] The plasma brain natriuretic peptide level on admission can predict the neural function recovery degree of the 3 months＇ phase in patients with acute ischemic stroke.

关 键 词：脑利钠肽 缺血性脑卒中 梗死部位 梗死体积 改良的Rankin量表 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]