老年脑梗死患者血浆中B型脑钠肽的变化特征及其临床意义

The variation features and clinical significance of B-type natriuretic peptide in Elderly Patients with Cerebral Infarction

目的观察老年脑梗死（cerebral infarction，CI）患者血浆中B型脑钠肽（brainnatriuretic peptide，BNP）水平的变化特征，探讨BNP在CI中的临床应用意义。方法选择60例老年CI患者为观察组，58名体检健康者为对照组；60例CI患者依据病程将CI分为急性期（发病3d内）亚组和亚急性期（发病3～10d）亚组；60例CI患者根据头颅MRI分型将脑梗死为大面积脑梗死（病灶直径〉5cm）亚组和非大面积脑梗死（病灶直径≤5cm）亚组。检测各组和亚组血浆中的BNP水平与进行比较分析。结果CI组血浆BNP水平显著高于对照组（P〈0．01）；CI组急性期亚组血浆BNP含量明显高于对照组（P〈0．01），也显著高于亚急性期亚组（P〈0．01）；大面积CI亚组血浆BNP含量显著高于非大面积CI亚组（P〈0．01）。结论急性期和大面积CI老年患者血浆BNP水平明显升高，提示BNP可能在老年CI发生过程中起着重要作用，可望成为CI诊断指标。

Objective To discuss the variation features of plasma B-type natriuretic peptide （BNP） in elderly patients with cerebral infarction （CI） and its clinical significance. Methods 60 elderly patients with CI were selected to be observation group while 58 norm were selected to be control group; according to CI course, the 60 elderly patients in observation group, were sub-divided into 2 subgroups： acute subgroup （onset within 3 days） and subacute subgroup （occurrence for 3 to 10 days）, and according to head MRI typing, the 60 patients in observation group were subdivided into 2 subgroups： massive CI subgroup （lesion diameter 〉 5cm） and non-massive CI subgroup （lesion diameter≤5cm）; the levels of plasma BNP of the patients in each group and each subgroup were detected and a comparative analysis was made. Results The level of plasma BNP in observation group was much higher than that in control group （P〈0.01）; the content of plasma BNP in acute subgroup was obviously higher than that in control group and higher than that in subacute subgroup （P〈0.01）; the content of plasma BNP in massive CI subgroup was higher than that in non-massive CI subgroup （P〈0.01）. Conclusions The level of plasma BNP in elderly patients with acute massive CI increases obviously, which indicates that BNP plays an important role in the pathogenesis of CI in the elderly, and it may be regarded as the diagnostic index for CI.