Fukuhara Kousuke, Ogata Toshiyasu, Takeshita Sho, Tsuboi Yoshio
Department of Neurology, Faculty of Medicine, Fukuoka University, Japan.
eNeurologicalSci. 2019 Dec 2;18:100217. doi: 10.1016/j.ensci.2019.100217. eCollection 2020 Mar.
An increased B-type natriuretic peptide (BNP) level is associated with cardioembolic stroke because of atrial fibrillation. However, data associating the measurement time of BNP and clinical influence of BNP are limited. Herein, we examined the utility of BNP level for prediction of stroke severity when accounting for measurement time. We retrospectively registered 327 patients admitted within 7 days from onset of ischemic stroke. We collected information on patients' background, stroke risk factors, subtype and severity, and outcome at discharge. Measurement of BNP was performed by chemiluminescent enzyme immunoassay. Patients were divided into 3 groups according to the time of BNP measurement from disease onset. Multivariate analyses were performed to evaluate the association of BNP value with outcome after patients were grouped according to BNP measurement time. Of the 327 patients, the numbers of patients whose BNP was measured within 24 h of symptom onset, between 24 and 48 h of symptom onset, and after 48 h of symptom onset were 102, 92, and 133, respectively. Favourable outcome at discharge was negatively correlated with BNP value in patients with a BNP level measured within 24 h of stroke onset. BNP value may be useful for prediction of stroke outcome if measured within 24 h after stroke onset.
由于心房颤动，B型利钠肽（BNP）水平升高与心源性栓塞性卒中相关。然而，将BNP的测量时间与BNP的临床影响相关联的数据有限。在此，我们在考虑测量时间的情况下，研究了BNP水平对预测卒中严重程度的效用。我们回顾性登记了327例在缺血性卒中发病7天内入院的患者。我们收集了患者的背景、卒中危险因素、亚型和严重程度以及出院时的结局等信息。BNP的测量采用化学发光酶免疫测定法。根据从疾病发作开始测量BNP的时间，将患者分为3组。在根据BNP测量时间对患者进行分组后，进行多变量分析以评估BNP值与结局之间的关联。在这327例患者中，症状发作后24小时内、症状发作后24至48小时内以及症状发作后48小时后测量BNP的患者人数分别为102例、92例和133例。在卒中发作后24小时内测量BNP水平的患者中，出院时的良好结局与BNP值呈负相关。如果在卒中发作后24小时内测量，BNP值可能有助于预测卒中结局。
