1 Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan City, Hubei Province, China.
2 Department of Intensive Care Unit, Xiangyang Hospital, Hubei University of Medicine, Xiangyang City, Hubei Province, China.
J Intensive Care Med. 2018 Dec;33(12):663-670. doi: 10.1177/0885066616683677. Epub 2017 Jan 1.
: The role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertensive intracerebral hemorrhage (HICH) is poorly understood. This study aimed to investigate the secretion pattern of NT-proBNP in patients with HICH and to assess its relationship with hematoma size, hyponatremia, and intracranial pressure (ICP).
: This prospective study enrolled 147 isolated patients with HICH. Blood samples were obtained from each patient, and values of serum NT-proBNP, hematoma size, blood sodium, and ICP were collected for each patient.
: The peak-to-mean concentration of NT-proBNP was 666.8 ± 355.1 pg/mL observed on day 4. The NT-proBNP levels in patients with hematoma volume >30 mL were significantly higher than those in patients with hematoma volume <30 mL ( P < .05). In patients with severe HICH, the mean concentration of NT-proBNP was statistically higher than that in patients with mild-moderate HICH ( P < .05), and the mean level of NT-proBNP in hyponatremia group was significantly higher than that in normonatremic group ( P < .05). In addition, the linear regression analysis indicated that serum NT-proBNP concentrations were positively correlated with ICP ( r = .703, P < .05) but negatively with blood sodium levels only in patients with severe HICH ( r = -.704, P < .05). The serum NT-proBNP levels on day 4 after admission were positively correlated with hematoma size ( r = .702, P < .05).
: The NT-proBNP concentrations were elevated progressively and markedly at least in the first 4 days after HICH and reached a peak level on the fourth day. The NT-proBNP levels on day 4 were positively correlated with hematoma size. There was a notable positive correlation between plasma NT-proBNP levels and ICP in patients with severe HICH. Furthermore, only in patients with severe HICH, the plasma NT-proBNP levels presented a significant correlation with hyponatremia, which did not occur in patients with mild-moderate HICH.
脑钠肽前体 N 端（NT-proBNP）在高血压性脑出血（HICH）患者中的作用尚不清楚。本研究旨在探讨 HICH 患者 NT-proBNP 的分泌模式，并评估其与血肿大小、低钠血症和颅内压（ICP）的关系。
这项前瞻性研究纳入了 147 例孤立性 HICH 患者。采集每位患者的血样，并采集每位患者的血清 NT-proBNP 值、血肿大小、血钠和 ICP 值。
第 4 天观察到 NT-proBNP 的峰均值浓度为 666.8±355.1pg/mL。血肿量>30ml 的患者 NT-proBNP 水平明显高于血肿量<30ml 的患者（P<0.05）。在重度 HICH 患者中，NT-proBNP 的平均浓度明显高于轻度-中度 HICH 患者（P<0.05），且低钠血症组的 NT-proBNP 平均水平明显高于正常血钠组（P<0.05）。此外，线性回归分析表明，血清 NT-proBNP 浓度与 ICP 呈正相关（r=0.703，P<0.05），但仅在重度 HICH 患者中与血钠水平呈负相关（r=-0.704，P<0.05）。入院后第 4 天的血清 NT-proBNP 水平与血肿大小呈正相关（r=0.702，P<0.05）。
NT-proBNP 浓度在 HICH 后至少前 4 天内逐渐升高，在第 4 天达到峰值。第 4 天的 NT-proBNP 水平与血肿大小呈正相关。在重度 HICH 患者中，血浆 NT-proBNP 水平与 ICP 之间存在显著的正相关。此外，仅在重度 HICH 患者中，血浆 NT-proBNP 水平与低钠血症呈显著相关，而在轻度-中度 HICH 患者中则没有这种相关性。
