重型颅脑创伤患者血浆N-端脑钠肽前体与高敏C反应蛋白水平的关系

发布时间：2018-05-06 05:09

本文选题：重型颅脑创伤 + 脑钠肽　；参考：《中南大学》2013年硕士论文

【摘要】：背景颅脑创伤的发生率占全身各部位创伤的约20%,致死率和致残率均居首位。重型颅脑创伤(severe traumatic brain injury, sTBI)的预后尤其不佳。脑钠肽(brain natriuretic peptide, BNP)在重型颅脑创伤中的作用日渐引起人们的关注。重型颅脑创伤后血浆高敏C反应蛋白(high-sensitivity C reactive protein, hsCRP)水平的升高往往预示患者死亡的极高风险。但是,国内外罕见报导颅脑创伤患者血浆N-端脑钠肽前体(N-terminal pro-B-type natriuretic peptide, NT-proBNP)与hsCRP水平的关系的研究。目的研究重型颅脑创伤患者发病早期血浆N-端脑钠肽前体与高敏C反应蛋白水平的关系。方法以2011年3月～2013年4月我院神经外科收治的伤后24h内28例重型颅脑创伤(GCS3～7)患者为颅脑创伤组(sTBI组),以20例健康体检正常人为对照组(Con组),在患者入院后1h内采集静脉血,采用电化学发光法、免疫透射比浊法分别测定血浆NT-proBNP与hsCRP水平。结果 sTBI组伤后24h内的血浆NT-proBNP、hsCRP水平显著高于Con组,差异有统计学意义(P0.05)。以Con组与sTBI组作为一个整体,相关分析显示：血浆NT-proBNP水平与hsCRP水平呈显著正相关(r=0.799,P0.01)。平均颅内压(ICP)升高的患者(平均ICP15mmHg, n=14)的血浆NT-proBNP与hsCRP水平显著高于ICP可控制组(平均ICP15mmHg, n=14, P0.05). 结论血浆NT-proBNP水平在重型颅脑创伤患者伤后24小时内显著升高,与伤后高炎症反应及高颅内压密切相关。提示血浆NT-proBNP水平有可能成为监控重型颅脑创伤患者病情严重程度、评估患者预后的一个有价值的生化标志物。
[Abstract]:Background The incidence of craniocerebral trauma is about 20% of all parts of the body, the mortality and disability rate are the first. The prognosis of severe traumatic brain injury (sTBI) is especially poor. The role of brain natriuretic peptide (BNP) in severe traumatic brain injury has attracted more and more attention. The elevation of plasma Gao Min C-reactive protein high-sensitivity C reactive protein (hsCRP) level in patients with severe traumatic brain injury often indicates a high risk of death. However, the relationship between plasma N-terminal pro-B-type natriuretic peptide (NT-proBNPs) and hsCRP levels in patients with traumatic brain injury is rarely reported at home and abroad. Purpose To study the relationship between plasma N-terminal brain natriuretic peptide precursor and Gao Min C-reactive protein level in patients with severe traumatic brain injury. Method From March 2011 to April 2013, 28 patients with severe craniocerebral trauma (GCS37 / 7) were treated in our hospital from March 2011 to April 2013. Twenty-eight patients with severe craniocerebral trauma were treated as TBI group and 20 healthy persons as control group. Venous blood was collected within 1 hour after admission. The plasma levels of NT-proBNP and hsCRP were measured by electrochemiluminescence and immunoturbidimetry. Result The level of plasma NT-proBNPhsCRP in sTBI group was significantly higher than that in Con group within 24 hours after injury, and the difference was statistically significant (P 0.05). The correlation analysis between Con group and sTBI group showed that there was a significant positive correlation between plasma NT-proBNP level and hsCRP level. The plasma levels of NT-proBNP and hsCRP in patients with elevated mean intracranial pressure (ICP 15 mm Hg, ng 14) were significantly higher than those in the ICP controllable group (mean ICP 15 mm Hg, n 14, P 0 05). Conclusion Plasma NT-proBNP level increased significantly within 24 hours after injury in patients with severe craniocerebral trauma, which was closely related to high inflammatory response and high intracranial pressure. The results suggest that plasma NT-proBNP level may be a valuable biochemical marker for monitoring the severity of severe traumatic brain injury and evaluating the prognosis of the patients.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R651.15

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