氨基末端脑钠肽前体与老年高血压脑出血患者脑水肿的关系

Relationship between NT-proBNP and cerebral edema in elderly patients with hypertensive intracerebral hemorrhage

目的通过观察老年高血压脑出血患者血浆氨基末端脑钠肽前体(NT-proBNP)的动态变化,探讨血浆NT-proBNP水平与脑水肿的关系。方法收集2015年3月至2017年3月在我院接受治疗老年高血压脑出血患者120例,根据治疗方式分为手术A组(60例)与非手术B组(60例)。另择取60例老年高血压患者作为对照C组进行对比研究。分别对三组患者发病后6 h、24 h、72 h、120h、168 h以及240 h六个时间节点每位患者的NT-proBNP含量变化情况与脑部水肿程度变化情况进行记录分析。探究NT-proBNP浓度水平与患者脑水肿间的关系。结果 A、B两组患者在6 h、24 h、72 h、120 h、168 h和240 h的NT-proBNP含量较C组明显升高,差异显著,P <0. 05,统计学意义显著。A、B两组均在24 h起明显出现脑水肿情况,A组患者于72 h水肿达高峰,而B组则在120 h水肿达高峰,但在120 h后,A组患者NT-proBNP含量明显低于B组; C组无脑水肿表现,NT-proBNP含量无明显变化;患者NT-proBNP含量水平与每位患者脑水肿程度呈正相关(r=0. 685,P <0. 05)。同时,患者神经功能受损越严重其NT-proBNP水平越高。结论 NT-proBNP与老年高血压脑出血患者关系密切,对患者NT-proBNP含量的有效监测能更早地对患者病情作出评估,进而有效降低患者脑出血病死率以及致残率,临床意义重大。

Objective The clinical relationship between the N-terminal pro-brain natriuretic peptide（NTproBNP） and cerebral edema in elderly patients with hypertension suffering from cerebral hemorrhage was investigated. Methods A total of 120 senior patients with hypertensive cerebral hemorrhage admitted to our hospital from March 2015 to March 2017 were analyzed retrospectively. All the elderly hypertensive cerebral hemorrhage patients were divided into Group A（60 patients） and Group B（60 patients）. Only the patients in Group A were performed the operation. The other 60 cases of hypertension patients were chosen as control group（Group C）. The levels of NT-proBNP and cerebral edema of patients in three groups were measured at 6 h,24 h,72 h,120 h,168 h and 240 h,and then all the data were recorded and analyzed. The relationship between NT-proBNP concentration and the level of cerebral edema was analyzed. Results The levels of NT-proBNP in Group A and B at 6 h,24 h,72 h,120 h,168 h and 240 h were significantly higher than those of Group C and the difference was statistically significant（P〈0.05）. Cerebral edema appeared in both Group A and B after 24 h. The patients in Group A reached the peak at 72 h while the patients in Group B peaked at 120 h. But after 120 h,the level of NT-proBNP in Group A was lower than that of Group B. There was no cerebral edema in Group C. The level of NT-proBNP had no change in Group C. NT-proBNP level and cerebral edema were positively correlated（r =0. 685,P〈0. 05）. At the same time,the more serious neurological impairment the patients got,the higher level of NT-proBNP was. Conclusion NTproBNP is closely related with hypertensive cerebral hemorrhage in senior patients. The effective monitoring of NTproBNP levels is helpful for the early evaluation of disease,and accordingly effectively reduces the mortality and disability of patients with cerebral hemorrhage. Therefore it is greatly meaningful for clinical practices.