pro-BNP和FIB联合检测对老年高血压脑出血后并发脑水肿患者甘露醇治疗效果的评价

Evaluation of pro-BNP and FIB combined detection in the treatment of mannitol in elderly patients with cerebral edema after HICH

目的:探讨甘露醇治疗老年高血压脑出血(HICH)并发脑水肿的疗效及其对血清B型钠尿肽前体(pro-BNP)和纤维蛋白原(FIB)变化的影响。方法:对2015年1月—2015年12月收治的96例老年HICH并发脑水肿患者的临床资料进行回顾性分析,动态监测患者血清pro-BNP和FIB的变化,分析其与美国国立卫生研究院卒中量表(NIHSS)评分的关系,采用改良Rankin量表(mRS)对患者预后进行亚组分析。结果:治疗后第3天患者的pro-BNP,FIB水平及NIHSS评分较治疗前均呈轻度增高;治疗后第6,9,12天较治疗前均显著降低(P<0.05)。脑水肿患者血清pro-BNP,FIB水平与NIHSS评分均呈显著正相关(r=0.381,r=0.296,P<0.05)。预后良好组患者血清pro-BNP,FIB水平均显著低于同期预后不良组,差异均有统计学意义(P<0.05)。结论:血清pro-BNP,FIB水平变化与甘露醇治疗HICH并发脑水肿患者的疗效及预后效果有一定关系,可以通过监测其变化指导治疗及分析患者预后情况。

Objective:To investigate the efficacy of mannitol in the treatment of cerebral edema in elderly patients with hypertensive cerebral hemorrhage(HICH)and its effect on changes of serum B-type natriuretic peptide precursor(pro-BNP)and fibrinogen(FIB).Methods:The clinical data of 96 elderly patients with HICH complicated with cerebral edema admitted from January 2015 to December 2015 were retrospectively analyzed,and the changes of serum pro-BNP and FIB in patients were dynamically monitored.The relationship between the scales(NIHSS)scores and subgroup analysis of the patients′prognosis according to the modified Rankin scale(mRS)of the patients 3 months later.Results:The pro-BNP,FIB levels,and NIHSS scores of patients on the 3rd day after treatment were slightly higher than before treatment.At 6,9,and 12 days,it was significantly lower than before treatment(P<0.05).The levels of serum pro-BNP and FIB in patients with cerebral edema were significantly positively correlated with the NIHSS score(r=0.381,r=0.296,P<0.05).Serum pro-BNP and FIB levels of patients with good prognosis were significantly lower than those with poor prognosis in the same period,and the differences were statistically significant(P<0.05).Conclusion:The changes of serum pro-BNP and FIB are related to the efficacy and prognosis of mannitol in the treatment of patients with HICH complicated with cerebral edema.The changes can be monitored to guide the treatment and analyze the prognosis of patients.