NT-proBNP 对缺血性脑卒中预后的预测价值：一项前瞻性队列研究的系统评价和荟萃分析。

Prognostic Value of NT-proBNP After Ischemic Stroke: A Systematic Review and Meta-analysis of Prospective Cohort Studies.

机构信息

Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China.

Department of Neurosurgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.

出版信息

J Stroke Cerebrovasc Dis. 2020 Apr;29(4):104659. doi: 10.1016/j.jstrokecerebrovasdis.2020.104659. Epub 2020 Feb 14.

DOI:10.1016/j.jstrokecerebrovasdis.2020.104659

PMID:32067852

Abstract

BACKGROUND

Many studies have evaluated the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and its prognostic value in ischemic stroke. However, a widespread consensus has not been reached. Therefore, we completed a meta-analysis to evaluate the prognostic significance of NT-proBNP for mortality and functional outcome in patients with ischemic stroke.

METHODS

We performed a systematic search and review using the PubMed and EMBASE databases to identify literature that reported a correlation between NT-proBNP and mortality and functional outcome in ischemic stroke patients.

RESULTS

Eleven studies inclusive of 10,498 patients met the inclusion criteria. Elevated plasma NT-proBNP levels were associated with increased risk of mortality in ischemic stroke patients (all-cause mortality: odds ratio [OR] = 2.43, 95% confidence interval [CI] 1.62-3.64, P < .001, I=74.3%; cardiovascular mortality: OR = 2.01, 95% CI 1.55-2.61, P < .001, I = 42.6%). In addition, unfavorable functional outcomes were observed in patients with higher levels of NT-proBNP (OR = 1.68, 95% CI 1.13-2.50, P = .01, I = 90.8%) after ischemic stroke.

CONCLUSIONS

This meta-analysis demonstrates that NT-proBNP could be a predictor of mortality and functional outcome in ischemic stroke patients.

摘要

背景

许多研究评估了 N 端脑利钠肽前体（NT-proBNP）与缺血性脑卒中及其预后价值之间的关系。然而，尚未达成广泛共识。因此，我们进行了一项荟萃分析，以评估 NT-proBNP 对缺血性脑卒中患者死亡率和功能结局的预后意义。

方法

我们使用 PubMed 和 EMBASE 数据库进行了系统搜索和综述，以确定报告 NT-proBNP 与缺血性脑卒中患者死亡率和功能结局之间相关性的文献。

结果

符合纳入标准的研究共有 11 项，共纳入 10498 例患者。升高的血浆 NT-proBNP 水平与缺血性脑卒中患者的死亡风险增加相关（全因死亡率：优势比 [OR] = 2.43，95%置信区间 [CI] 1.62-3.64，P <.001，I=74.3%；心血管死亡率：OR=2.01，95%CI 1.55-2.61，P <.001，I=42.6%）。此外，在缺血性脑卒中患者中，较高的 NT-proBNP 水平与不良的功能结局相关（OR=1.68，95%CI 1.13-2.50，P=0.01，I=90.8%）。