贵州医科大学学报

2019, v.44;No.229(10) 1228-1232

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血浆N-末端脑力肽前体与老年急性脑梗死患者预后的关系
Relationship between Plasma NT-proBNP Level and Prognosis of Acute Cerebral Infarction in Elderly Patients

张万义;孟庆伟;胡卫民;苏燕玲;
ZHANG Wanyi;MENG Qingwei;HU Weimin;SU Yanling;Emergency Department of Beijing Liangxiang Hospital,Fangshan District;Neurology Department of Beijing Liangxiang Hospital,Fangshan District;General Internal Department of Beijing Liangxiang Hospital,Fangshan District;

摘要(Abstract):

目的:探讨血浆N-末端脑力肽前体(NT-proBNP)与老年急性脑梗死患者预后的关系。方法:120例急性脑梗死老年患者作为研究组,根据脑梗死原因分为大血管动脉粥样硬化性脑梗死、小血管闭塞性脑梗死、心源性脑栓死及病因不明性脑梗死,再根据美国国立卫生研究院卒中量表(NIHSS)评分将脑梗死患者分为轻度神经功能缺损(≤7分)和重度神经功能缺损(>7分)2个等级;另外选取同期110例老年缺血性脑血管病患者作为对照组;所有受检者均在入院时检测血浆NT-proBNP水平,比较2组患者、不同原因脑梗死患者、两个等级NIHSS评分脑梗死患者的血浆NT-proBNP水平及死亡率,Logisitic回归分析心源性脑梗死的独立危险因素。结果:研究组患者的血浆NT-proBNP水平显著高于对照组,差异有统计学意义(P<0.05);心源性脑梗死患者血浆NT-proBNP水平及死亡率显著高于其他脑梗死患者,差异有统计学意义(P<0.01或P<0.05);NIHSS评分>7分脑梗死患者血浆NT-proBNP水平显著高于评分≤7分脑梗死患者,差异有统计学意义(P<0.05);Logisitic回归分析结果显示,年龄(OR=1.037,95%CI为1.012~1.062)、心房纤颤(OR=9.660,95%CI为4.130~17.190)及NT-proBNP(OR=25.700,95%CI为10.070~65.600)是心源性脑梗死的独立危险因素(P<0.01)。结论:不同预后急性脑梗死患者血浆NT-proBNP水平存在差异。
Objective: To investigate the relationship between plasma NT-proBNP levels and acute cerebral infarction in elderly patients. Methods: 120 elderly patients were collected as the study group. According to the etiology, the patients were divided into three groups: macrovascular atherosclerotic cerebral infarction group, small vessel occlusive cerebral infarction group, cardiogenic cerebral embolism group and unknown cerebral infarction group. Meanwhile, according to the score of National Institutes of Health Stroke Scale(NIHSS), the patients with cerebral infarction were divided into two grades: mild neurological deficit(≤7) and severe neurological deficit(>7). In addition, 110 elderly patients with ischemic cerebrovascular disease were selected as the control group.Plasma NTproBNP levels were detected at the time of admission, and plasma NTproBNP levels and mortality were compared in two groups of patients with different causes of cerebral infarction and two grades of NIHSS scores. Independent risk factors of cardiogenic cerebral infarction were analyzed by Logisitic regression analysis. Results: The plasma NT-proBNP level in the study group was significantly higher than that in the control group(P<0.05).The plasma NT-proBNP level and mortality of the patients with central cerebral embolism were significantly higher than those of other groups(P<0.01 or P<0.05).The level of plasma NT-proBNP in patients with cerebral infarction with NIHSS score>7 was significantly higher than that in patients with cerebral infarction with score≤7, and the difference was statistically significant(P<0.05). Logisitic regression analysis showed that age, atrial fibrillation and plasma NT-proBNP were the independent risk factors of cardiogenic cerebral embolism. Conclusions: There were differences in plasma NT-proBNP levels in patients with acute cerebral infarction with different prognosis.

关键词(KeyWords): 脑梗死,急性;老年人;N-末端脑力肽前体;血管动脉粥样硬化;心源性脑梗死;美国国立卫生研究院卒中量表;回归分析
cerebral infarction,acute;the elderly;plasma NT-brain natriuretic peptide precursor;vascular atherosclerosis;cardiogenic cerebral infarction;National Institutes of Health Stroke Scale;regression analysis

Abstract:

Keywords:

基金项目(Foundation): 北京市科技计划课题(Z141100004914012)

作者(Authors): 张万义;孟庆伟;胡卫民;苏燕玲;
ZHANG Wanyi;MENG Qingwei;HU Weimin;SU Yanling;Emergency Department of Beijing Liangxiang Hospital,Fangshan District;Neurology Department of Beijing Liangxiang Hospital,Fangshan District;General Internal Department of Beijing Liangxiang Hospital,Fangshan District;

DOI: 10.19367/j.cnki.1000-2707.2019.10.023

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