重型颅脑损伤患者N末端脑利钠肽前体的变化及意义  

The significance of the changes of NT-pro BNP in severe brain injury patients

作　　者：朱登安[1] 魏晓艳[1] 陈华文[2] 冯俊[2] 

机构地区：[1]武警湖北总队医院急诊科,武汉430061 [2]华中科技大学同济医学院附属同济医院急诊科

出　　处：《临床急诊杂志》2013年第8期360-362,共3页Journal of Clinical Emergency

摘　　要：目的:探讨重型颅脑损伤后N末端脑利钠肽前体(NT-proBNP)变化及意义。方法:对2008-03-2011-03收治的68例重型颅脑损伤患者资料进行回顾性分析。按Glasgow评分(GCS)分为GCS6-8分组和GCS3-5分组,按EF分为EF≥50%组、EF<50%组,按血清cTnI水平分cTnI<0.04,cTnI>0.5组和0.04≤cTnI≤0.5组,按预后分生存组和死亡组,30例健康体检者作为对照组,抽血取血清检测cTnI和NT-proBNP的水平;床边彩色超声测量EF,分析患者NT-proBNP与GCS、cTnI、左室EF和预后的关系。采用SPSS13.0分析软件对结果进行统计学分析。结果:40例重型颅脑损伤患者出现NT-proBNP升高,与对照组比,GCS6-8分组和GCS3-5分组NT-proBNP均明显升高(P<0.05),死亡组较生存组升高明显(P<0.05),与cTnI<0.04比较,cTnI>0.5组和0.04<cTnI<0.5组NT-proBNP水平较高(P<0.05),与EF<50%组比,EF≥50%组NT-proBNP水平较高(P<0.05)。结论:重型颅脑损伤患者NT-proBNP升高可能与心肌损伤有关,早期干预,减少颅脑外伤的病死率。Objective：To explore the changes and significance of N terminal proBNP （Brain Natriuretic Pep tide） in severe brain injury patients. Method：The clinic data of 68 patients with severe brain injury between March 2008 and March 2011 were analyzed. The patients are divided into GCS6 8 group and GCS3 5 group by their Glasgow coma scale （GCS） ;CTn1〉0.5 group,0.04〈CTnl〈0.5 group and CTnl〈0.04 group by the cTnI levels; survival group and death group by prognosis. Thirty healthy persons in the center of our hospital were investigated as control group. The expression and relation of N-terminal proBNP,serum cardiac troponin I,left ventricular ejec- tion fraction were analyzed. Result： Forty of the 68 patents with sever brain injury experienced NT-proBNP de- crease. The patients with GCS6--8 group and GCS3--5 group showed significantly higher NT-proBNP compared with control group（P〈0.05）. The death group sees a more obvious increase than the survival group （P〈0.05）. The patients with cTnI〉0. 5 group and 0.04〈cTn1〈0.5 group showed significantly higher NT proBNP when compared with cTnI〈0.04 group （P〈0.05）. Compared with the GCS6 8 group,the GCS3 5 group has more patients with an abnormal serum NT-proBNP level. Conclusion： The mechanism of increasing of NT-proBNP may he correlated with myocardial injury in sever brain injury patients, we should adopt early intervention to decrease the fatality of sever brain injury.

关 键 词：颅脑损伤 重度 脑钠肽 肌钙蛋白I 射血分数 

分 类 号：R651[医药卫生—外科学]