N端脑钠肽前体与急性脑梗死相关性的研究
发布时间：2019-06-05 20:41
【摘要】：目的:分析急性脑梗死(Acute Cerebral Infarction,ACI)患者血浆N端脑钠肽前体(N terminal pro brain natriuretic peptide,NT-pro BNP)的病理变化及与不同梗死面积、梗死部位、颈动脉粥样硬化(Carotid artery atherosclerosis,CAA)、神经功能缺损程度及预后的相关性。方法:将发病24小时内的90例急性脑梗死患者作为病例组(研究对象来自于2015年2月至2016年9月在蚌埠医学院第二附属医院神经内科住院患者),同期健康体检者40例为对照组。检验并比较病例组入院24h、治疗7天、治疗14天血浆NT-pro BNP水平及对照组入选当日清晨血浆NT-pro BNP水平,病例组依照头颅MRI结果按照梗死面积、梗死部位比较入院24h、治疗7天、治疗14天血浆NT-pro BNP水平;应用彩色多普勒超声检测病例组颈动脉内膜中层厚度(intima media thickness,IMT)并与入院24 h血浆NT-pro BNP水平比较;通过采用美国国立卫生研究院卒中量表(the national institutes of health stroke scale,NIHSS)对入院时病例组患者的神经功能缺损程度进行分组并与入院24 h血浆NT-pro BNP水平比较并追踪预后。结果:病例组患者血浆NT-pro BNP水平明显高于对照组(t=16.840,P=0.00),入院24 h血浆NT-pro BNP水平最高,后逐渐下降,2周时最低;重症亚组入院24h血浆NT-pro BNP水平明显高于轻症亚组,轻症亚组高于健康对照组(F值=102.386,P=0.00),且预后渐好转;大面积脑梗死亚组入院24 h、第7天、第14天血浆NT-pro BNP水平明显高于中面积脑梗死亚组,中面积脑梗死亚组血浆NT-pro BNP水平明显高于小面积脑梗死亚组(F值=188.694、200.641、181.731,P均=0.00);前、后循环脑梗死血浆NT-pro BNP水平比较差异无统计学意义(F值=0.000,P0.05);且梗死组入院24h血浆NT-pro BNP水平与NIHSS、IMT呈正相关(r=0.692、0.672,P均=0.00)。结论:急性期时,脑梗死患者血浆NT-pro BNP水平有明显升高,梗死面积越大,升高越明显,但与梗死部位并无相关性,患者血浆NT-pro BNP水平在预测颈动脉粥样硬化危险性上具有重要意义,其在预测可能病程和结局中也具有重要的参考价值。作为动态监测急性脑梗死患者血清学的重要指标,入院24h血浆NT-pro BNP水平联合NIHSS评分可以更加充分有力地对急性脑梗死严重程度和疾病的发展情况进行分析和预测。
[Abstract]:Objective: to analyze the pathological changes of plasma N-terminal brain natriuretic peptide precursor (N terminal pro brain natriuretic peptide,NT-pro BNP (N terminal pro brain natriuretic peptide,NT-pro BNP) in patients with acute cerebral infarction (Acute Cerebral Infarction,ACI) and its relationship with different infarction area, infarction site and carotid atherosclerosis (Carotid artery atherosclerosis,CAA). Correlation between the degree of neurological deficit and prognosis. Methods: 90 patients with acute cerebral infarction within 24 hours were selected as the case group (the subjects were hospitalized in the Department of Neurology, the second affiliated Hospital of Bengbu Medical College from February 2015 to September 2016). At the same time, 40 cases of healthy physical examination were taken as the control group. The plasma NT-pro BNP level of the case group was tested and compared with that of the control group on the morning of the day of admission for 24 hours, 7 days of treatment, 14 days of treatment and 24 hours of admission according to the size of infarction and the location of infarction in the case group according to the MRI results of the head. The plasma NT-pro BNP level was 7 days and 14 days after treatment. The carotid intima-media thickness (intima media thickness,IMT) in the case group was measured by color Doppler ultrasound and the plasma NT-pro BNP level was compared with that at 24 hours after admission. The neurological deficit degree of the patients in the admission group was divided into two groups by using the National Institutes of Health Stroke scale (the national institutes of health stroke scale,NIHSS) and compared with the plasma NT-pro BNP level at 24 hours after admission and the prognosis was followed up. Results: the plasma NT-pro BNP level in the case group was significantly higher than that in the control group (t = 16.840, P 鈮，
本文编号：2493809
[Abstract]:Objective: to analyze the pathological changes of plasma N-terminal brain natriuretic peptide precursor (N terminal pro brain natriuretic peptide,NT-pro BNP (N terminal pro brain natriuretic peptide,NT-pro BNP) in patients with acute cerebral infarction (Acute Cerebral Infarction,ACI) and its relationship with different infarction area, infarction site and carotid atherosclerosis (Carotid artery atherosclerosis,CAA). Correlation between the degree of neurological deficit and prognosis. Methods: 90 patients with acute cerebral infarction within 24 hours were selected as the case group (the subjects were hospitalized in the Department of Neurology, the second affiliated Hospital of Bengbu Medical College from February 2015 to September 2016). At the same time, 40 cases of healthy physical examination were taken as the control group. The plasma NT-pro BNP level of the case group was tested and compared with that of the control group on the morning of the day of admission for 24 hours, 7 days of treatment, 14 days of treatment and 24 hours of admission according to the size of infarction and the location of infarction in the case group according to the MRI results of the head. The plasma NT-pro BNP level was 7 days and 14 days after treatment. The carotid intima-media thickness (intima media thickness,IMT) in the case group was measured by color Doppler ultrasound and the plasma NT-pro BNP level was compared with that at 24 hours after admission. The neurological deficit degree of the patients in the admission group was divided into two groups by using the National Institutes of Health Stroke scale (the national institutes of health stroke scale,NIHSS) and compared with the plasma NT-pro BNP level at 24 hours after admission and the prognosis was followed up. Results: the plasma NT-pro BNP level in the case group was significantly higher than that in the control group (t = 16.840, P 鈮，
本文编号：2493809
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