Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
J Neurotrauma. 2020 Oct 15;37(20):2211-2218. doi: 10.1089/neu.2020.7110. Epub 2020 Jun 25.
The purpose of this study was to analyze brain natriuretic peptide (BNP) serum levels of patients with chronic subdural hematoma (cSDH) and their clinical implication. Patients with cSDH who underwent surgery in our department between November 2016 and October 2019 were eligible for enrollment in the study. Patients with recurrent bleedings, traumatic brain injury, cSDH associated with other intracranial pathologies, and those with a history of congestive heart failure, renal or endocrine disease were excluded. We measured BNP serum levels pre- and post-operatively and at discharge. The BNP values were analyzed with respect to patient medical history and neurological condition. The Glasgow Coma Scale score and the modified Rankin Scale score classified the clinical and neurological condition at the time of admission and discharge, respectively. The data of 100 surgically treated patients with cSDH (mean age 73.2, range 42 - 94 years, male/female 3.5:1) were analyzed. Pre-operative BNP serum levels (BNP-1) were elevated in 67% of the patients ( = 67; median = 101.6 pg/mL; < 0.001). These serum levels increased after surgery (p < 0.001) and decreased thereafter ( < 0.001), reaching a level at discharge (day 7) that was not statistically different from BNP-1 ( > 0.05). In addition, elevated BNP-1 showed a significant statistical association with the presence of atrial fibrillation ( < 0.01) and antiplatelet and/or anticoagulant therapy ( < 0.01). This study provides new evidence regarding BNP serum levels and their secretion pattern in patients with cSDH. Whether BNP-1 can predict the long-term functional outcome of patients with cSDH is being investigated in this ongoing prospective study.
本研究旨在分析慢性硬脑膜下血肿（cSDH）患者的脑钠肽（BNP）血清水平及其临床意义。本研究纳入 2016 年 11 月至 2019 年 10 月期间在我科接受手术的 cSDH 患者。排除复发性出血、创伤性脑损伤、cSDH 合并其他颅内病变以及充血性心力衰竭、肾脏或内分泌疾病病史的患者。我们在术前、术后和出院时测量了 BNP 血清水平。分析了 BNP 值与患者的病史和神经状况的关系。格拉斯哥昏迷量表评分和改良 Rankin 量表评分分别在入院和出院时对临床和神经状况进行分类。分析了 100 例接受手术治疗的 cSDH 患者（平均年龄 73.2 岁，范围 42-94 岁，男女比例为 3.5:1）的数据。术前 BNP 血清水平（BNP-1）升高的患者占 67%（ = 67；中位数=101.6 pg/mL； < 0.001）。术后 BNP 血清水平升高（p < 0.001），此后降低（ < 0.001），出院时（第 7 天）的水平与 BNP-1 无统计学差异（ > 0.05）。此外，BNP-1 升高与心房颤动（ < 0.01）和抗血小板和/或抗凝治疗（ < 0.01）的存在有显著统计学关联。本研究提供了关于 cSDH 患者 BNP 血清水平及其分泌模式的新证据。正在进行的前瞻性研究正在调查 BNP-1 是否可以预测 cSDH 患者的长期功能预后。
