脑出血急性期血浆N端脑钠肽前体浓度变化与预后的关系

Plasma concentration of N-terminal fragment of pro-brain natriuretic peptide and prognosis in patients with acute cerebral hemorrhage

目的探讨脑出血患者血浆N端脑钠肽前体(NT-proBNP)浓度变化与预后的关系。方法采用前瞻性对照研究。脑出血组42例,为发病24h内住院的脑出血患者;对照组28例,为本院同期的健康体检者。观察指标:入院时和第7天血浆NT-proBNP水平,患者一般情况,出血部位,出血量,格拉斯哥昏迷(GCS)评分和NIHSS评分,随访6个月时的预后。结果脑出血组血浆NT-proBNP水平高于对照组,第7天的NT-proBNP水平较入院时的低(P<0.05)。大量出血或GCS评分≤8分者,NT-proBNP水平分别高于中、小量出血及GCS>8分者(P<0.05)。随访6个月时,血浆NT-proBNP水平高的脑出血者,其神经功能缺损恢复较差。结论脑出血后急性期血浆NT-proBNP水平升高。出血量越大,病情越重,血浆NT-proBNP水平越高,预后越差。因此,血浆NT-proBNP水平有可能成为监测脑出血患者病情变化和预测预后的重要及快捷指标之一。

Objective To investigate that the relationship of plasma concentration of amino-terminal pro-brain natriuretic pepfide（NT-proBNP）and prognosis in patients with acute cerebral hemorrhage.Methods A prospective control study was used.There were 42 patients in the cerebral hemorrhage group,who were in hospital within 24h after onset,and 28 cases in the healthy control group.The plasma level of NT-proBNP on admission and the seventh day,general conditions,bleeding site,volume of hemorrhage,Glasgow Coma Score（GCS）,National Institute of Health stroke scale（NIHSS）,and prognosis of follow-up for six months were observed.Results The plasma level of NT-proBNP in the cerebral hemorrhage group was higher than in control（P〈0.05）and was lower on the seventh day than on admission（P〈0.05）.It was higher in patients with large hemorrhage or GCS≤8 than in patients with medium and small hemorrhage（P〈0.05）or GCS8（P〈0.05）.The higher the plasma level of NT-proBNP in patients with cerebral hemorrhage was,the poorer recovery of neurologic impairment for follow-up after six months.Conclusion The plasma level of NT-proBNP is increased at acute phase after cerebral hemorrhage.The bigger the volume of cerebral hemorrhage,the higher the plasma level of NT-proBNP,and the worse the prognosis.Therefore,the plasma level of NT-proBNP could be one of important and shortcut indicators for monitoring the changes of condition and predicting prognosis in patients with cerebral hemorrhage.