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脑钠肽水平作为急性缺血性卒中诊断和预后的标志物

Levels of brain natriuretic peptide as a marker for the diagnosis and prognosis of acute ischemic stroke.

作者信息

Sayan Saadet, Kotan Dilcan

机构信息

Department of Neurology, SB Sakarya University Research and Training Hospital, Sakarya, Turkey.

Department of Neurology, Faculty of Medicine, Sakarya University, Sakarya, Turkey.

出版信息

Arch Med Sci Atheroscler Dis. 2016 May 9;1(1):e16-e22. doi: 10.5114/amsad.2016.59751. eCollection 2016.

Abstract

INTRODUCTION

The relationships between plasma levels of brain natriuretic peptide (BNP) and severity and location of stroke, prognosis, and infarct volume were investigated in acute ischemic stroke patients who presented within the first 24 hours (h) of stroke.

MATERIAL AND METHODS

Brain natriuretic peptide levels were tested in 40 patients and 30 healthy controls. Infarct volume was automatically calculated by multi-slice computed tomography. Disease severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at presentation, 24 h, 72 h and the 28 day. Progression was defined as an increase of more than two points in the NIHSS scores.

RESULTS

The mean BNP levels were 284.16 ±382.79 at presentation and 273.78 ±451.91 at 72 h in the patient group, whereas the mean BNP level was 25.29 ±13.47 in controls. There was a statistically significant difference between the two groups ( < 0.001). Differences in BNP levels among patient subgroups according to the TOAST and OCSP classifications were not statistically significant ( = 0.534, = 0.943, respectively). There was no significant correlation between plasma BNP level and infarct volume or NIHSS scores ( = 0.5, = 0.07). A positive correlation was found between BNP levels and the length of the hospitalization period ( = 0.03 and = 0.33). There was no statistically significant relationship between elevated plasma BNP levels and progression of disease ( = 0.08).

CONCLUSIONS

Plasma BNP levels were increased in the acute phase of stroke; therefore, BNP could be used as a biomarker for morbidity and mortality, even in patients without cardiac failure.

摘要

引言

在发病后24小时内就诊的急性缺血性卒中患者中,研究了血浆脑钠肽(BNP)水平与卒中严重程度、部位、预后及梗死体积之间的关系。

材料与方法

对40例患者和30例健康对照者检测脑钠肽水平。通过多层计算机断层扫描自动计算梗死体积。在就诊时、24小时、72小时和28天时,使用美国国立卫生研究院卒中量表(NIHSS)评估疾病严重程度。病情进展定义为NIHSS评分增加超过2分。

结果

患者组就诊时平均BNP水平为284.16±382.79,72小时时为273.78±451.91,而对照组平均BNP水平为25.29±13.47。两组间差异有统计学意义(<0.001)。根据TOAST和OCSP分类的患者亚组间BNP水平差异无统计学意义(分别为=0.534,=0.943)。血浆BNP水平与梗死体积或NIHSS评分无显著相关性(=0.5,=0.07)。发现BNP水平与住院时间呈正相关(=0.03,=0.33)。血浆BNP水平升高与疾病进展无统计学意义上的关系(=0.08)。

结论

卒中急性期血浆BNP水平升高;因此,即使在无心力衰竭的患者中,BNP也可作为发病率和死亡率的生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd26/5421533/3bf7a1052978/AMS-AD-1-27505-g001.jpg

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