超声IVC直径与血BNP水平检测对脑损伤患者术后CSWS与SIADH的鉴别价值  

VALUE OF ULTRASONIC IVC DIAMETER AND BLOOD BNP LEVEL IN DIFFERENTIAL DIAGNOSIS OF POSTOPERATIVE CSWS AND SIADH IN PATIENTS WITH BRAIN INJURY

作　　者：叶杰 谢聪 牛文勇 YE Jie;XIE Cong;NIU Wenyong(Chongqing Dazu District People′s Hospital,Chongqing 402360,China)

机构地区：[1]重庆市大足区人民医院,402360

出　　处：《中国煤炭工业医学杂志》2022年第2期221-224,共4页Chinese Journal of Coal Industry Medicine

基　　金：重庆市科技计划项目(编号:cstc2017yykfA1136216)。

摘　　要：目的探讨超声下腔静脉(Ultrasound inferior vena cava,IVC)直径与血清脑钠肽(Serum brain natriuretic peptide,BNP)检测在脑损伤患者术后脑性盐耗综合征(Cerebral salt consumption syndrome,CSWS)和抗利尿激素分泌不当综合征(mproper secretion of antidiuretic hormone syndrome,SIADH)鉴别中的价值。方法选取2017年1月—2021年5月在该院治疗的脑损伤术后CSWS患者37例,SIADH患者30例,比较二组临床资料、IVC、BNP等指标。结果CSWS和SIADH患者性别、年龄、体重指数等临床一般资料比较差异无统计学意义(P<0.05);CSWS组患者手术前后BNP变化值和24h尿钠变化值分别为(675.54±98.87)pg/ml和(-25.22±4.03),明显高于SIADH组(P<0.05),而IVC变化值为(-2.12±0.68)mm,明显低于SIADH患者(P<0.05);BNP变化值与24h尿钠变化值呈正相关(r=0.769,P<0.05);BNP、IVC变化值鉴别CSWS和SIADH的ROC曲线下面积分别为0.932和0.984(P<0.05),截断值分别为550.72pg/ml和-1.12mm,诊断灵敏性分别为79.80%和90.00%,特异性分别为92.50%和100.00%,以上差异均有统计学意义。结论超声IVC直径和血BNP水平在鉴别脑损伤术后CSWS、SIADH中有较高的价值。Objective To explore the value of ultrasound inferior vena cava(IVC)diameter and serum brain natriuretic peptide(BNP)detection in the differential diagnosis of cerebral salt wasting syndrome(CSWS)and inappropriate antidiuretic hormone secretion syndrome(SIADH)in patients with brain injury after operation.Methods From January 2017 to May 2021,thirty seven patients with CSWS and thirty patients with SIADH after brain injury surgery in our hospital were selected,the clinical data,IVC,BNP and other indicators of the two groups were compared.Results There was no statistical significance in gender,age,body mass index and other general clinical data between CSWS and SIADH patients(P<0.05).The changes of BNP and 24 h urinary sodium in CSWS group before and after operation were(675.54±98.87)pg/ml and(-25.22±4.03)respectively,which were significantly higher than those in SIADH group(P<0.05),while the changes of IVC were(-2.12±0.68)mm,which were significantly lower than SIADH patients(P<0.05);There was a positive correlation between BNP and 24 h urinary sodium(r=0.769,P<0.05).The area under the ROC curve for the identification of CSWS and SIADH by BNP and IVC changes was 0.932 and 0.984,respectively,P<0.05,the cut-off value was 550.72 pg/mL and-1.12 mm,respectively,and the diagnostic sensitivity was 79.80%and 90.00%,respectively,the specificity was 92.50%and 100.00%,respectively,the above differences were statistically significant.Conclusion Ultrasound IVC diameter and blood BNP level are of high value in differentiating CSWS and SIADH after brain injury.

关 键 词：下腔静脉直径 脑钠肽 脑损伤 脑性盐耗综合征 抗利尿激素分泌不当综合征 

分 类 号：R74[医药卫生—神经病学与精神病学]