Azizkhani Reza, Keshavarz Es'haq
Department of Emergency Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2016 Dec 27;5:191. doi: 10.4103/2277-9175.190983. eCollection 2016.
Head trauma is one of the most common reasons for emergency department (ED) care. Over the past decade, initial management strategies in mild and moderate head trauma have become focused on selective computed tomography (CT) use based upon presence or absence of specific aspects of patient history and/or clinical examination which has received more attention following reports of increased cancer risk from CT scans. Recently changes in serum brain natriuretic peptide (BNP) levels following head trauma have been studied. We investigated the changes in serum levels of BNP in patients with mild and moderate head trauma, in whom the first brain CT scanning was normal.
This study is a cross-sectional, descriptive research. It was performed in patients with mild and moderate head trauma. Forty-one patients with isolated mild and moderate traumatic brain injury (Glasgow Coma Scale = 9-15) were included. First brain CT scans were obtained during 2 h after ED arrival and the second one after 24 h. Plasma BNP levels were determined using a specific immunoassay system.
Twenty-three patients were in Group A (with normal first and second brain CT) and 18 patients in Group B (with normal first and abnormal second brain CT). With = 0.001, serum BNP level = 9.04 was determined for differentiating two groups.
We concluded that serum BNP level is higher in patients with mild and moderate head trauma with delayed pathologic changes in second brain CT relative to patients with mild and moderate head trauma and with normal delayed brain CT.
头部创伤是急诊科就诊的最常见原因之一。在过去十年中,轻度和中度头部创伤的初始管理策略已聚焦于根据患者病史和/或临床检查的特定方面是否存在来选择性使用计算机断层扫描(CT),随着CT扫描致癌风险增加的报道,这一策略受到了更多关注。最近,人们对头部创伤后血清脑钠肽(BNP)水平的变化进行了研究。我们调查了首次脑部CT扫描正常的轻度和中度头部创伤患者血清BNP水平的变化。
本研究为横断面描述性研究。研究对象为轻度和中度头部创伤患者。纳入41例孤立性轻度和中度创伤性脑损伤患者(格拉斯哥昏迷量表评分为9 - 15分)。在急诊科就诊后2小时内进行首次脑部CT扫描,24小时后进行第二次扫描。使用特定的免疫分析系统测定血浆BNP水平。
A组23例患者(首次和第二次脑部CT均正常),B组18例患者(首次脑部CT正常,第二次异常)。以α = 0.001确定血清BNP水平为9.04用于区分两组。
我们得出结论,相对于轻度和中度头部创伤且延迟脑部CT正常的患者,轻度和中度头部创伤且第二次脑部CT有延迟病理变化的患者血清BNP水平更高。