重度颅脑创伤后血浆脑钠肽浓度的变化

The changes of plasma brain natriuretic peptide after severe traumatic brain injury

目的探讨重度颅脑创伤(TBI)后血浆脑钠肽(BNP)浓度的变化。方法选取30例重度TBI患者(TBI组)和10例健康志愿者(对照组),应用免疫放射分析技术测定患者伤后1-2、4-5、7-8和10-11d共4个时间段血浆BNP浓度。结果 TBI患者伤后初始BNP浓度较对照组可升高7.3倍(P<0.01)。弥散性蛛网膜下腔出血(SAH)组BNP浓度在伤后7-8d内较无或仅少量SAH患者增高,颅高压组BNP浓度高于颅内压正常患者(P<0.01)。结论血浆BNP浓度在伤后即迅速升高,且在广泛SAH或颅内压增高患者中可持续升高;血浆BNP浓度升高与不良预后密切相关。

Objective To investigate the changes of plasma brain natriuretic peptide（BNP） after severe traumatic brain injury（TBI）. Methods Plasma concentration of BNP was detected by immunoradiometric assay in four time periods of in 1-2, 4-5, 7-8 and 10-11 days after injury in 30 severe TBI patients（group TBI） and 10 healthy volunteers（group C）. Results The initial plasma BNP concentration in group TBI was 7. 3 times more than that in group C （ P〈0. 01 ）. Plasma BNP concentration in 7-8 d after injury was progressively higher in patients with diffused subarchnoid hemorrhage（SAH） than that in those without or mild SAH （P〈0. 01）. Plasma BNP concentration was higher in the patients with elevated intracranial pressure （ICP） than that with normal ICP （P〈0. 01 ）. Conclusion Plasma BNP concentrations are elevated shortly after head injury and are continuously elevated during the acute phase in the patients with extensive SAH or elevated ICP. The higher plasma BNP is closely related with poor outcomes in severe TBI patients.