Department of Neurology, Deqing People's Hospital, Huzhou, China; Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Clin Neurol Neurosurg. 2021 Dec;211:107021. doi: 10.1016/j.clineuro.2021.107021. Epub 2021 Nov 9.
Elevated levels of B-type natriuretic peptide (BNP) can predict the prognosis of patients with acute ischemic stroke (AIS). However, the association between BNP levels and the clinical outcome in patients with AIS receiving intravenous thrombolysis treatment remains controversial. Therefore, this study aimed to analyse the role of BNP in patients with ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) therapy.
This retrospective study involved 251 patients who were diagnosed with ischemic stroke and had undergone intravenous thrombolysis. The BNP level in blood was assessed before the treatment of thrombolysis. Outcome events include poor functional outcome, and mortality defined as modified Rankin Scale (mRS) scores of 3-6,and 6 respectively.
In multivariate logistic regression, BNP > 78 pg/mL (odds ratio, 2.726 [95% CI, 1.440-5.159]; P = 0.002) was an independent risk factor for 3-month poor outcomes in patients with ischemic stroke treated with thrombolysis, whereas BNP > 103 pg/mL (odds ratio, 4.204 [95% CI, 1.382-12.788]; P = 0.011) was significantly associated with the 3-month mortality. The area under the curve (AUC) of BNP before thrombolysis to predict poor functional outcomes at 3 months were 0.679 (95% CI, 0.618-0.737; P < 0.001), and mortality at 3 months was 0.802 (95% CI, 0.747-0.849; P < 0.001), respectively.
An early increase in BNP levels before intravenous thrombolysis was independently associated with 3-month poor outcomes and mortality. Moreover, the pre-thrombolytic BNP level may serve as a more reliable marker for predicting mortality in patients with ischemic stroke.
B 型利钠肽（BNP）水平升高可预测急性缺血性脑卒中（AIS）患者的预后。然而，接受静脉溶栓治疗的 AIS 患者 BNP 水平与临床结局之间的关系仍存在争议。因此，本研究旨在分析接受重组组织型纤溶酶原激活剂（rt-PA）静脉溶栓治疗的缺血性脑卒中患者中 BNP 的作用。
本回顾性研究纳入了 251 例诊断为缺血性脑卒中并接受静脉溶栓治疗的患者。在溶栓治疗前评估了血液中的 BNP 水平。结局事件包括功能不良结局和死亡率，定义分别为改良 Rankin 量表（mRS）评分 3-6 分和 6 分。
多变量 logistic 回归分析显示，溶栓治疗的缺血性脑卒中患者 BNP >78 pg/mL（比值比，2.726 [95%CI，1.440-5.159]；P=0.002）是 3 个月预后不良的独立危险因素，而 BNP >103 pg/mL（比值比，4.204 [95%CI，1.382-12.788]；P=0.011）与 3 个月死亡率显著相关。溶栓前 BNP 预测 3 个月功能不良结局的曲线下面积（AUC）为 0.679（95%CI，0.618-0.737；P<0.001），预测 3 个月死亡率的 AUC 为 0.802（95%CI，0.747-0.849；P<0.001）。
溶栓前 BNP 水平的早期升高与 3 个月预后不良和死亡率独立相关。此外，溶栓前 BNP 水平可能是预测缺血性脑卒中患者死亡率的更可靠标志物。
