高血压脑出血患者血清N末端前体脑钠肽和肌钙蛋白T的变化和意义

Changes and clinical significance of NT-pro-B-type natriuretic peptide and troponin T in hypertensive patients with cerebral hemorrhage

目的:观察急性高血压脑出血患者血清NT-pro-BNP和肌钙蛋白T的动态变化,探讨NT-pro-BNP的水平与出血量及病情程度的关系。方法:2011年2月-2012年12月收治的高血压脑出血患者40例,检测入院时(发病24 h内)和入院第3天的血清NT-pro-BNP和肌钙蛋白水平,以健康人20例为对照。根据患者入院时的CT结果计算脑出血量,记录入院时格拉斯哥昏迷评分(GCS评分),观察不同脑出血量和GCS评分患者血清NT-pro-BNP水平的变化。结果:急性脑出血组发病24 h以内血清NT-pro-BNP和肌钙蛋白T水平均明显高于正常对照组(P<0.01),第3天的NT-pro-BNP和肌钙蛋白T水平较入院时明显增高(P<0.01);大量出血组NT-pro-BNP水平高于中、小量脑出血组(P<0.01);GCS评分≤8分的患者血清NT-pro-BNP水平高于GCS评分>8分的患者。结论:急性高血压脑出血患者的NT-pro-BNP和肌钙蛋白T的水平明显升高。NT-pro-BNP的水平可以作为判断高血压脑出血患者病情轻重的指标。

Objective：To observe the changes in the levels of troponin T and NT-pro-B-type natriuretic peptide （NT-pro-BNP） in hypertensive patients suffering from cerebral hemorrhage, and to investigate the relationship be tween NT-pro-BNP and blood volume with severity of the disease. Methods：The levels of NT-pro-BNP and tropo- nin T were measured when admitted （within 24 hours of onset） and 3 days later in 40 patients with hypertensive cerebral hemorrhage from February 2011 to December 2012. Twenty healthy people were recruited to serve as controls. The blood volume of cerebral hemorrhage was calculated according to CT result, while the Glascow coma score was recorded when patients were admitted. The changes in levels of NT-pro-BNP and troponin T were compared among patients with different hemorrhage volume and GCS score. Results：The levels of NT-pro BNP and troponin T were significantly increased in patients with hypertensive cerebral hemorrhage as compared with, that of control group（P〈0.01）, and their levels were higher on the 3rd day than that on the day of admission （P〈 0.01）. The NT-pro-BNP level in patients with large hemorrhage or GCS^8 were higher than in patients with small hemorrhage or GCS^8 （P%0.01）. Conclusions： The levels of NT-pro-BNP and troponin T were elevated after cerebral hemorrhage. The levels of NT-pro-BNP can be used to indicate the severity of hypertensive cerebral hemorrhage .