急性缺血性脑卒中患者氨基末端-B型利纳肽前体水平与静脉溶栓预后的相关性分析

Influence of the Level of NT-pro-BNP to the Clinical Results of Thrombolysis in Patients with Actue Ischemic Stroke(AIS)

目的:探讨血清氨基末端-B 型利钠肽(N-terminal B-type natriuretic peptide,NT-proBNP)水平与急性缺血性脑卒中患者静脉溶栓后 90 天预后的相关性。方法:回顾性分析 2017 年 6 月至 2018 年 6 月在我院接受静脉溶栓的急性缺血性脑卒中患者发病时血清 NT-proBNP 水平与溶栓后 90 天预后情况的相关性,同时引入影响预后的相关危险因素进行多因素 Logistic 回归分析。结果:共入组患者 106 例,其中男性 79 例,女性 27 例,血清 NT-proBNP 水平与入院时 NIHSS 基线评分(rs=0.352,P=0.003)、年龄(rs=0.377,P=0.002)呈正相关;血清 NT-pro-BNP 水平升高在心源性脑卒中患者最为常见,其次为大动脉粥样硬化性卒中(Z=40.387,P<0.001);多因素Logistic 回归分析结果显示:血清 NT- proBNP 水平[OR95%CI=(1.021,35.717)]、空腹血糖升高[OR 95%CI=(1.127,1.926)]和入院时 NIHSS 评分高[OR 95%CI=(1.018,1.231)]是急性缺血性脑卒中患者溶栓后 90 天内死亡的独立危险因素。结论:血清 NT-proBNP 水平升高可能导致急性缺血性卒中静脉溶栓患者发病 90 天内死亡率增高、预后不良。

Objective:To explore the correlation between the levels of N-terminal B-type natriuretic peptide(NT-proBNP)and the clinical results of actue ischemic stroke(AIS)patients after intravenous thrombolysis with rt - PA. Methods:All the acute ischemic stroke pateints who aririved hospital in 4.5 h treated with rt-PA from June 2017 to June 2018 were enrolled in this study. The data of baseline characters,the plasma levels of NT-proBNP and clinical results of 90 days after thrombolysis were analyzed. the influence between the level of NT-proBNP and clinical results after thrombolysis were analyzed with the multiple factors logistic regression models. Results:106 patients were included in this study,of which 79 were males and 27 were females. The plasma levels of NT-proBNP was positively relate to the baseline NIHSS value(r=0.352,P=0.003)and age(r=0.377,P=0.003). Through the rank sum test,the increase of serum NT-proBNP level was most obvious in patients with cardiogenic stroke,secondly with large artery atherosclerosis (Z=40.387,P<0.001). Multivariate Logistic regression analysis revealed that the level of NT-proBNP[OR 95%CI=(1.021,35.717)]was an independent risk factor for mortality within 90 days after intravenous thrombolysis in acute ischemic stroke patients,as well as elevated fasting glucose levels[OR 95%CI=(1.127,1.926)]and higher baseline NIHSS values[OR 95%CI=(1.018,1.231)]. Conclusion:The increased level of NT-proBNP is a potential risk factor for mortality and the poor clinical outcome at 90 days after thrombolytic therapy in acute stroke patients.