血浆脑钠肽水平与急性缺血性脑卒中预后的相关性研究

Correlation of Brain Natriuretic Peptide in Blood Plasma and Prognosis of Acute Ischemic Stroke Patients

目的:探讨血浆脑钠肽(BNP)与急性缺血性脑卒中预后的相关性。方法:急性缺血性脑卒中患者212例,依据住院期间是否死亡分为存活组和死亡组,比较2组相关临床资料,并分析血浆BNP和美国国立卫生研究院卒中量表(NIHSS)评分与预后的相关性。结果:急性缺血性脑卒中患者住院期间的预后死亡率为15.09%(32/212);多因素分析结果显示房颤(OR=3.819)、大面积脑梗死(OR=6.228)、血浆BNP浓度≥280 ng/L(OR=5.191)、NIHSS评分≥13分(OR=3.536)为脑卒中预后死亡的独立危险因素;NIHSS评分≥13分筛查预后的灵敏度、特异度、准确度分别为89.1%、75.0%、87.0%;血浆BNP≥280 ng/L筛查预后的灵敏度、特异度、准确度分别为85.0%、81.3%、84.4%。结论:房颤、大面积脑梗死、血浆BNP水平及NIHSS评分为急性缺血性脑卒中预后死亡的高危因素,其中血浆BNP水平和NIHSS评分可能可作为预后死亡的预测指标。

Objective： To explore the correlation of brain natriuretic peptide （BNP） in blood plasma and prog- nosis of acute ischemic stroke patients. Methods： Two hundred and twelve patients of acute ischemic stroke were divided into survival group and death group according to whether death or not during they were in hospital. The clinical data of 2 groups were compared, and diagnostic effect with BNP and NIHSS score screening progno- sis of acute ischemic stroke were analyzed. Results： The death rate of prognosis of acute ischemic stroke in the duration of hospital stay was 15.09% （32/212）. Multiple risk factors analysis showed that atrial fibrillation （OR= 3.819）, cerebral infarction of a large area （OR=6.228）, BNP of blood plasma ≥280 ng/L （OR=5.191） and NIHSS score≥ 13 （OR=3.536） were the independent risk factors of prognosis death of acute ischemic stroke. The sensi- tivity, specificity and accuracy of NIHSS seore≥ 13 screening prognosis were respectively 89.1%, 75.0% and 87.0%, and BNP≥280 ng/L respectively 85.0%, 81.3% and 84.4%. Conclusion： Atrial fibrillation, cerebral in- farction of a large area, BNP of blood plasma and NIHSS score are the high risk factors of prognosis death of acute ischemic stroke. Of the total, BNP of blood plasma and NIHSS score may be predictive indexes of progno- sis death of acute ischemic stroke.