N-末端脑利钠肽前体检测对心源性脑栓塞的早期诊断价值

Early Diagnostic Value of N-terminal Pro-brain Natriuretic Peptide on Patient with Cardioembolism

目的:探讨血浆N-末端脑利钠肽前体(NT-proBNP)检测对心源性脑栓塞(CE)的早期诊断价值。方法:急诊收治入院的200例急性脑梗死患者,按照TOAST分型标准进行分为大动脉粥样硬化型(n=58)、小动脉闭塞型(n=76)、心源性脑栓塞(n=41)、其他明确病因型(n=15)和不明原因型(n=10),比较各型在急诊检测的NT-proBNP水平。结果:CE组患者血浆NT-proBNP水平显著高于TOAST其他亚型组(P均<0.01),其他亚型组间的NT-proBNP无明显差异。当NT-proBNP取值(cut-off值)为412.42 pg/ml时,将CE组与其他TOAST各亚型组筛选出的敏感度为75.0%,特异度为88.7%。结论:急性脑梗死中,CE患者血浆NT-proBNP水平显著升高,急诊检测血浆NT-proBNP水平有助于CE的及早诊断。

Objective： To explore the early diagnostic value of N-terminal pro-brain natriuretic peptide （NT- proBNP） in patients with cardioembolism. Methods：200 patients with acute cerebral infarction in departments of emergency were classified according to the TOAST criteria： large artery atherosclerosis （LAA ,n=58）, small artery occlusion lacunar （SAO, n =76）, cardioembolism （CE, n =41 ）, stoke of other demonstrated etiology （SOE, n = 15 ） and stoke of other undermonstrated etiology （SUE,n=10）. The NT-proBNP level of plasma were compared among the groups. Results： The NT-proBNP levels of plasma in patients with CE group was significantly higher than that of non CE group （all P 〈0.01）,and all the non CE group had no significant difference. The cut-off values,sensitivity, specificity of the plasma NT-proBNP concentration suitable to distinguish CE from non-CE：412.42pg/ml,75.0%, 88.7%, P 〈 0.01. Conclusions： Early detection of plasma NT-proBNP levels in emergency department contribute to the early diagnosis of cardioembolism.