血清NT-proBNP、NLRP3水平与急性缺血性卒中患者恶性脑水肿的关系  

Relationships between serum NT-proBNP and NLRP3 levels and malignant brain edema in patients with acute ischemic stroke

作　　者：王丽轩[1] 贾建普[1] 洪震[1] 张乐国[1] 张俊玲[1] 李阔[1] WANG Lixuan;JIA Jianpu;HONG Zhen;ZHANG Leguo;ZHANG Junling;LI Kuo(Department of Neurology,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院神经内科,河北沧州061000

出　　处：《山东医药》2022年第22期11-14,共4页Shandong Medical Journal

基　　金：河北省医学科学研究课题计划项目(20211278)。

摘　　要：目的探讨血清N端脑利钠肽前体(NT-proBNP)、NOD样受体热蛋白结构域相关蛋白3(NLRP3)水平与急性缺血性卒中(AIS)患者恶性脑水肿(MBE)的关系。方法选取302例AIS患者,根据是否发生MBE分为MBE组和非MBE组。收集患者基线资料,采用酶联免疫吸附法检测血清NT-proBNP、NLRP3。多因素Logistic回归分析AIS患者MBE的影响因素,采用受试者工作特征(ROC)曲线分析血清NT-proBNP、NLRP3水平对AIS患者MBE的预测价值。结果302例AIS患者共发生MBE 47例(15.56%)。与非MBE组比较,MBE组血清NT-proBNP、NLRP3水平更高(P均<0.05)。多因素Logistic回归分析显示,美国国立卫生研究院卒中量表评分(OR=1.175,95%CI:1.089~1.267)、NT-proBNP(OR=1.002,95%CI:1.001~1.003)、NLRP3(OR=2.527,95%CI:1.745~3.661)为AIS患者MBE的独立危险因素(P均<0.05)。ROC曲线分析结果显示,血清NT-proBNP、NLRP3水平联合预测AIS患者MBE的曲线下面积大于二者单独预测(P均<0.05)。结论血清NT-proBNP、NLRP3水平升高是AIS患者MBE独立危险因素,二者可作为AIS后MBE的辅助预测指标。Objective To investigate the relationships between serum N-terminal pro B type natriuretic peptide(NT-proBNP)and NOD-like receptor thermal protein domain associated protein 3(NLRP3)levels and malignant brain edema(MBE)in patients with acute ischemic stroke(AIS).Methods Totally 302 patients with AIS were selected and divided into the MBE and non-MBE groups according to whether MBE occurred.Baseline information was collected from patients and serum NT-proBNP and NLRP3 levels were measured by enzyme-linked immunosorbent assay.Multi-factor Logistic re⁃gression was used to analyze the factors influencing MBE in patients with AIS,and receiver operating characteristics(ROC)curves were used to analyze the predictive value of serum NT-proBNP and NLRP3 levels on MBE in patients with AIS.Results Forty-seven cases(15.56%)of MBE occurred in 302 patients with AIS.Serum NT-proBNP and NLRP3 levels were higher in the MBE group than in the non-MBE group(both P<0.05).Multi-factor Logistic regression analysis showed that National Institute of Health Stroke Scale(OR=1.175,95%CI:1.089 to 1.267),NT-proBNP(OR=1.002,95%CI:1.001 to 1.003),and NLRP3(OR=2.527,95%CI:1.745 to 3.661)were independent risk factors for MBE in patients with AIS(all P<0.05).ROC curve analysis showed that the area under the curve of serum NT-proBNP and NL⁃RP3 levels combined in predicting MBE of AIS patients was greater than that of each alone(both P<0.05).Conclusion Elevated serum NT-proBNP and NLRP3 levels are independent risk factors for MBE in patients with AIS and can be used as the secondary predictor of MBE after AIS.

关 键 词：急性缺血性卒中 恶性脑水肿 N末端前体B型钠尿肽 NOD样受体热蛋白结构域相关蛋白3 

分 类 号：R743[医药卫生—神经病学与精神病学]