非高血压性自发性脑出血与血B型脑钠肽水平的相关性研究

Study on the Relationship between Spontaneous Cerebral Hemorrhage and Serum B-type Brain Natriuretic Peptide

目的:观察非高血压性自发性脑出血患者血B型脑钠肽(BNP)水平,及BNP与脑出血时间、出血量、出血部位及病情严重程度的相关性。方法:对30例不伴有高血压的自发性脑出血患者发病1周内(急性期)进行BNP检测,记录患者一般情况、出血部位及出血量,并对患者做GCS评分。其中12例在发病24小时内入院者分别在入院24小时内和1周时各检测1次。结果:脑出血组患者血BNP水平较正常对照组显著降低(P<0.01);发病1周时的BNP水平低于发病24小时内(P<0.05),而GCS评分无统计学意义(P>0.05)。大量出血(LH)者、基底节、丘脑出血者及GCS评分≤8分者BNP水平分别低于中量出血(MH)者、小量出血(SH)者、脑叶出血者及GCS>8分者(P<0.05,P<0.01)。结论:非高血压性自发性脑出血患者出血后BNP水平显著降低;血BNP值与出血部位、出血时间、出血量及病情严重程度(GCS评分)均有明显相关。

Objective：To observe the level of B-type brain natriuretic peptide （BNP） during cerebral hemorrhage and the relationship between BNP and blood volume, site, and severity of the disease. Methods ：The BNP level was detected in the acute stage （within 1 week） of onset in 30 patients with spontaneous cerebral hemorrhage in the absence of hypertension. Of the patients,12 who were admitted to the hospital within 24 h after onset were detected for the BNP twice,within 24 h and in 1 week after admission, respectively. The status of patients and bleeding site and volume were recorded. Glasgow Coma Score （GCS） was conducted. Results ：The BNP level was dramatically decrease after hemorrhage onset（ P 〈0.01 ） ; that in 1 week was lower than that within 24 h （ P 〈 0,05 ）, but GCS was not significantly different （ P 〉 0.05 ）. The BNP level in patients with large hemorrhage, or basal ganglia or hypothalamic area bleeding site, or GCS ≤ 8 were lower than that in patients with medium or small hemorrhage （ P 〈 0.05 ）, or lobar bleeding, or GCS 〉 8 （ P 〈 0.01 ）. Conclusion： The BNP level was decreased after spontaneous cerebral hemorrhage. It was related to the site, volume, time and GCS.