急性脑梗死患者血浆BNP水平与自主活动能力恢复的相关性分析

Correlation analysis of plasma BNP level and undesirable recovery for ability of independent activity in patient with acute cerebral infarction

目的：探讨急性脑梗死患者血浆BNP水平与自主活动能力恢复的相关性。方法：检测112例急性脑梗死患者入院时的血浆BNP水平，并记录患者人院时的一般临床资料及生化指标，记录患者入院时的美国国立卫生院卒中量表（NIHSS）评分、按照患者入院14d的Barthel指数评分将患者分为自主活动能力恢复不良组（n=42例）及恢复良好组（n=70例），比较两组之间相关指标的差异。结果：与恢复良好组比较，自主活动能力恢复不良组患者入院时的收缩压（systolic pressure，SBP）、低密度脂蛋白胆固醇（low density lipoprotein cholesterin，LDL．C）、空腹血糖（fastingblood，glucose，FPG）、超敏C反应蛋白（hypersensitive c—reactive protein，hs．CRP）高于对照组（P〈0．05）；BNP、NIHSS评分亦显著高于对照组（P〈0．05）；多因素Logistic回归分析显示：人院NIHSS评分、SBP、hs-CRP、FPG、BNP与自主活动能力恢复不良呈独立正相关（P〈0．05）；ROC曲线分析显示：入院BNP水平预测自主活动能力恢复不良的曲线下面积（ROC AVC）为0．834（95％CI，0．586—0．932，P〈0．05），最佳的诊断截点值为296．4pg／m，敏感性和特异性分别为83．3％和84．2％。结论：急性脑梗死患者人院BNP水平与患者自主活动能力恢复密切相关，早期检测BNP水平对于评估急性脑梗死患者的自主活动能力的恢复具有一定临床意义。

Objective： To study the correlation of plasma BNP level and recovery for ability of independent activity in acute cerebral infarction （ACI） patients. Methods： When 112 ACI patients were admitted into hospital, plasma BNP levels were detected; the general clinical data, biochemical index as well as NIHSS upon admission were recorded, according to Barthel index upon 14 d of admission of hospital, the patients were divided into poor-recovery group （n=42 cases） and good-recovery group （n=70 cases）; the relevant index of two groups was compared. Results： SBP, LDL-C, FPG and hs-CRP of poor-recovery group were significantly higher than those of desirable group （P〈0.05）; BNP and NIHSS of undesirable group were significantly higher than that of good-recovery group （P〈0.05）; Logistic regression analysis showed that NIHSS, SBP, hs-CRP, FPG and BNP were positively correlated with the poor recovery of ability of independent activities（P〈0.05）; according to ROC curve analysis, the predicted ROC AUC on the undesirable recovery of independent activities capacity was 0.834 based on BNP levels （95% CI, 0.586-0.932, P〈0.05）; the best cut-offpoint value was 296.4 pg/mL while sensitivity and specificity was 83.3% and 84.2%. Conclusion： Plasma BNP is closely correlated with the recovery of independent activities capacity in ACI patients; the early detection of BNP level has a certain clinical significance for the evaluation of recovery of independent activity capacity in ACI patients.