脑血管意外患者血浆N端脑钠尿肽前体浓度变化及对预后的影响
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Research of Plasma Concentration of Amino-Terminal Pro-Brain Natriuretic Peptide and Prognosis Ipact in Ptients Suffering from of Cerebrovascular Accident
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    摘要:

    目的探讨N端脑钠尿肽前体在急性脑血管意外患者血浆中浓度变化及对预后的影响。方法纳入2005年8月至2007年4月期间我医学部收治的急性脑血管意外患者共137例,106名健康对照来自同期我院体检人群。检测所有对照和入院24h内患者的N端脑钠尿肽前体浓度,所有患者行心脏超声测定左室射血分数,并进行格拉斯哥评分和预后评分。比较病例组和对照组间N端脑钠尿肽前体浓度差别;比较不同N端脑钠尿肽前体浓度患者心功能衰竭发生率,分析N端脑钠尿肽前体水平与格拉斯哥评分和预后评分之间的相关关系。结果脑梗死组、脑出血组和蛛网膜下腔出血组N端脑钠尿肽前体浓度均较正常对照组显著增高(P<0.01);蛛网膜下腔出血组较其他病例亚组高(P=0.021),脑梗死组、脑出血组间无统计学差别(P>0.05);N端脑钠尿肽前体高浓度组急性心功能衰竭发生率与低浓度组无差别;N端脑钠尿肽前体浓度与格拉斯哥评分(r=-0.696,P=0.039)、预后评分(r=-0.726,P=0.008)均成负直线相关。结论脑血管意外亦可引起血浆N端脑钠尿肽前体浓度升高,其升高程度与疾病严重程度可能相关,可望作为病情严重程度和预后的判断指标。

    Abstract:

    Aim To investigate the plasma concentration of amino-terminal pro-brain natriuretic peptide (NT-proBNP) and prognosis impact in patients suffering from of cerebrovascular accident. Methods We selected 137 patients suffering from acute cerebrovascular accident in our department, from August 2005 to April 2006; and 106 healthy people, who came for body-check, as control. All the people received blood test for NT-proBNP, and all patients received echocardiogram examination for left ventricular ejection fraction (LVEF), Glasgow coma score (GCS) and Glasgow outcome score (GOS). According to the NT-proBNP result, the patients were divided into two groups:the high concentration group and the low concentration group. We compared the NT-proBNP concentration between the cases and control, the incidence of heart failure between different concentration groups of NT-proBNP;analyzed the linear correlation relationship between the concentration of NT-proBNP and GCS and GOS. Results The plasma concentrations of NT-proBNP in cerebral infarction group, cerebral hemorrhage group, and subarachnoid hemorrhage group were higher than in control (P<0.01), further more, the subarachnoid hemorrhage group showed highest level than the other groups (P<0.05). The high NT-proBNP concentration group showed the same incidence of heart failure as low group (P>0.05). There were negative linear correlation relationship between the plasma concentration of NT-proBNP and GCS (r=-0.696, P=0.039), GOS (r=-0.726, P=0.008). Conclusions cerebrovascular accident can independently cause the raise of plasma concentration of NT-proBNP, the degree of that can perhaps reflect the severity and prognosis of disease.

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方明,甄享凡,胡皓,黎春常,詹伟峰,曾红科.脑血管意外患者血浆N端脑钠尿肽前体浓度变化及对预后的影响[J].中国动脉硬化杂志,2008,16(4):311~313.

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  • 收稿日期:2007-08-14
  • 最后修改日期:2008-04-18
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