B型钠尿肽对心房颤动合并脑梗死急性期抗栓治疗选择的意义

发布时间：2018-04-19 03:28

  本文选题：脑梗死 + 心房颤动　； 参考：《上海交通大学学报(医学版)》2017年01期

【摘要】：目的·探讨B型钠尿肽(BNP)对心房颤动合并脑梗死急性期抗栓治疗选择的意义。方法·回顾性分析714例急性脑梗死合并心房颤动患者的临床资料。以BNP=912.5 pg/m L(第95分位数)为分界值,将患者分成2组,每组再根据不同的抗栓治疗,分为抗血小板组和抗凝组。比较入院时和治疗后21 d 2组患者的美国国立卫生研究院卒中量表(NIHSS)评分和改良的Rankin量表(m RS)评分,同时比较2组颅内出血、症状性颅内出血、消化道出血、脑梗死再发、深静脉血栓发生率及病死率。结果·对于BNP912.5 pg/m L的患者,抗凝治疗组的NIHSS评分(P=0.015)及m RS评分(P=0.031)改善比显著高于抗血小板治疗组;抗血小板治疗组病死率和脑梗死再发率高于抗凝治疗组,但差异无统计学意义;两治疗组所有出血、颅内出血、症状性颅内出血、消化道出血、深静脉血栓发生率比较,差异无统计学意义。对于BNP≤912.5 pg/m L的患者,两治疗组之间NIHSS评分及m RS评分改善比的差异无统计学意义;抗血小板治疗组病死率和脑梗死再发率高于抗凝治疗组,但差异无统计学意义;两治疗组所有出血、颅内出血、症状性颅内出血、消化道出血、深静脉血栓发生率比较,差异无统计学意义。结论·BNP912.5 pg/m L的心房颤动合并脑梗死急性期患者采用抗凝治疗,其疗效可能优于抗血小板治疗。
[Abstract]:Objective to investigate the significance of B type natriuretic peptide (BNP) in the treatment of atrial fibrillation with acute cerebral infarction.Methods the clinical data of 714 patients with acute cerebral infarction complicated with atrial fibrillation were retrospectively analyzed.The patients were divided into two groups by BNP=912.5 pg/m L (95 quartile). Each group was divided into antiplatelet group and anticoagulant group according to different antithrombotic therapy.The scores of NIHSS and modified Rankin scale were compared between the two groups on admission and 21 days after treatment. At the same time, intracranial hemorrhage, symptomatic intracranial hemorrhage, gastrointestinal hemorrhage and recurrent cerebral infarction were compared between the two groups.Incidence and mortality of deep venous thrombosis.Results for the patients with BNP912.5 pg/m L, the improvement ratio of NIHSS score (P0.015) and Mrs score (P0.031) in the anticoagulant treatment group was significantly higher than that in the antiplatelet treatment group, and the mortality and the recurrence rate of cerebral infarction in the antiplatelet treatment group were higher than those in the anticoagulant treatment group.There was no significant difference in the incidence of hemorrhage, intracranial hemorrhage, symptomatic intracranial hemorrhage, gastrointestinal hemorrhage and deep venous thrombosis between the two groups.For patients with BNP 鈮，

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