Department of Neurosurgery, Jinshan Hospital of Fudan University, Shanghai, China.
Clinical Medical Research Center, Jinshan Hospital of Fudan University, Shanghai, China.
J Surg Res. 2021 Oct;266:353-360. doi: 10.1016/j.jss.2021.04.018. Epub 2021 Jun 1.
The aim of this study was to investigate the secretion patterns of brain natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP) after traumatic brain injury (TBI) and to analyze the source of them in cerebrospinal fluid (CSF).
We synchronously measured BNP and NT-proBNP concentrations in paired CSF and plasma samples from 22 moderate to severe TBI patients and 40 healthy control patients. The CSF and/or plasma ratio of albumin (Q) was calculated daily. The BNP and NT-proBNP levels of CSF and plasma were compared between TBI patients and control patients.
CSF BNP and NT-proBNP levels peaked on day 3 after injury, as did the plasma BNP and NT-proBNP levels. The CSF BNP and NT-proBNP levels in TBI patients were elevated from day 1, which was significantly higher than control group (P < 0.05 and P < 0.01, respectively). However, in plasma, only NT-proBNP levels were significantly higher than in the control group from day 2 (P < 0.05). In addition, Q, defined as CSF BNP concentration and/or plasma BNP concentration, was significantly higher in TBI patients than in the control group (P < 0.01). However, Q remained within ranges of a mild to moderate dysfunction of blood-brain-barrier in TBI patients.
CSF BNP concentrations are elevated and peak on day 3 after moderate to severe TBI. CSF BNP may originate from the brain and may be a potential biomarker of TBI.
本研究旨在探讨脑利钠肽（BNP）和 N 末端 proBNP（NT-proBNP）在创伤性脑损伤（TBI）后的分泌模式，并分析其在脑脊液（CSF）中的来源。
我们同步测量了 22 例中重度 TBI 患者和 40 例健康对照患者的配对 CSF 和血浆样本中的 BNP 和 NT-proBNP 浓度。每天计算白蛋白（Q）的 CSF 和/或血浆比值。比较 TBI 患者和对照组患者的 CSF 和血浆中 BNP 和 NT-proBNP 水平。
CSF BNP 和 NT-proBNP 水平在损伤后第 3 天达到峰值，与血浆 BNP 和 NT-proBNP 水平相同。TBI 患者的 CSF BNP 和 NT-proBNP 水平从第 1 天开始升高，明显高于对照组（P < 0.05 和 P < 0.01）。然而，在血浆中，只有 NT-proBNP 水平从第 2 天开始明显高于对照组（P < 0.05）。此外，Q 定义为 CSF BNP 浓度和/或血浆 BNP 浓度，在 TBI 患者中明显高于对照组（P < 0.01）。然而，Q 仍处于 TBI 患者血脑屏障轻度至中度功能障碍的范围内。
CSF BNP 浓度在中重度 TBI 后升高，并在第 3 天达到峰值。CSF BNP 可能来源于大脑，可能是 TBI 的潜在生物标志物。
