脑出血患者术后死亡的预测指标  

Predictors of postoperative mortality in patients with cerebral hemorrhage

作　　者：蔡雪敏 汪海芹[1] 张爽[1] 李超梁[1] CAI Xuemin;WANG Haiqin;ZHANG Shuang;LI Chaoliang(Jiangmen Central Hospital,Jiangmen 529000,China)

机构地区：[1]广东省江门市中心医院,广东江门529000

出　　处：《中国医药科学》2019年第1期253-256,共4页China Medicine And Pharmacy

摘　　要：目的探讨脑脊液和血浆NT-proBNP水平以及脑电双频指数(BIS)对脑出血患者术后死亡的评估价值。方法选取2017年7月～2018年6月于江门市中心医院行急诊颅脑手术后转入重症监护室的脑出血患者64例,监测术后早期的NT-proBNP水平(脑脊液及血浆)和BIS数值。结果早期的NT-proBNP水平和BIS数值,是脑出血患者术后的危险因素。脑水肿高峰期,脑脊液与血浆NT-pro BNP水平呈正相关(P <0.01),二者与BIS数值无相关性(P> 0.05),同时二者对脑出血患者术后死亡的预测具有价值(P <0.01),其中脑脊液NTpro BNP的准确性更高(ROC曲线下面积为0.800)。结论早期NT-pro BNP水平和BIS数值是脑出血患者术后有效的死亡预测指标,且脑脊液NT-pro BNP水平更准确评估脑出血患者的预后。Objective To evaluate the value of cerebrospinal fluid and plasma NT-proBNP(N-terminal probrain natriuretic peptide)and bispectral index(BIS)in the evaluation of postoperative death in patients with cerebral hemorrhage.Methods 64 patients with cerebral hemorrhage who were transferred to the intensive care unit after emergency brain surgery in Jiangmen Central Hospital from July 2017 to June 2018 were selected.The early postoperative NT-proBNP levels(cerebrospinal fluid and plasma)and BIS were monitored.Results Early NT-proBNP levels and BIS values were risk factors for postoperative cerebral hemorrhage.At the peak of cerebral edema,cerebrospinal fluid was positively correlated with plasma NT-proBNP levels(P<0.01),and there was no correlation between them and BIS(P >0.05).Both of them had value in predicting postoperative death in patients with cerebral hemorrhage(P<0.01),in which the accuracy of cerebrospinal fluid NT-proBNP is higher(area under the ROC curve is 0.800).Conclusion Early NT-proBNP levels and BIS are effective predictors of postoperative mortality in patients with cerebral hemorrhage,and the level of NT-proBNP in cerebrospinal fluid is more accurate in assessing the prognosis of patients with cerebral hemorrhage.

关 键 词：脑出血 脑钠肽 N端脑钠肽前体 脑电双频指数 

分 类 号：R743.34[医药卫生—神经病学与精神病学]