动脉瘤性蛛网膜下腔出血患者人院氨基末端B型钠尿肽前体水平与神经源性心脏损伤的关系及其预后价值

摘要:目的探讨 动脉瘤性蛛网膜下腔出血(aSAH)患者入院氨基末端B型钠尿肽前体( NT-proBNP)水平与神经源性心脏损伤的关系及其预后价值。方法回顾性分析 2018年1月至2021年4月在我科接受治疗的aSAH患者资料,分析患者入院NT-proBNP水平与心肌损伤相关指标的关系,并探讨NT-proBNP水平是否与预后不良相关。结果共纳入 308例患者,其中预后不良55例(17.9%)。患者入院NT-proBNP水平与心肌肌钙蛋白T水平相关(r=0.454, P<0.001),且心电图异常组NT-proBNP水平高于正常组( P<0.05)。NT-proBNP 预测不良预后的ROC曲线下面积为0.665,最佳截断值为318.1 pg/mL。多因素分析显示NT-proBNP≥318.1 pg/mL是aSAH患者预后不良的独立危险因素。结论aSAH 患者入院血清NT-proBNP水平可能与神经源性心脏损伤相关,其水平升高对预测aSAH患者不良结局有一定的参考价值。

Relationship between level of N-terminal pro-brain natriuretic peptide and neurocardiogenic injury in patients with aneurysmal subarachnoid hemorrhage and its predictive value for prognosis

Abstract: Objective To investigate the correlation between the level of N-terminal pro-brain-type natriuretic peptide ( NT-proBNP)on admission and neurocardiogenic injury in the patients with aneurysmal subarachnoid hemorrhage ( aSAH) and explore the predictive value of NT-proBNP for prognosis of aSAH patients. Methods The clinical data of aSAH patients who received endovascular treatment in our department from January 2018 to April 2021 was retrospectively studied. The association between NT-proBNP levels on admission and myocardial injury-related indicators was analyzed, and the relationship between NT-proBNP levels on admission and poor prognosis of patients with aSAH was also explored. Results A total of 308 eligible patients were included in our study , including 55 patients with poor prognosis. The serum NT-proBNP level on admission in aSAH patients was significantly correlated with the level of cardiac troponin T (r= 0.454, P<0.001) , and the level of serum NT-proBNP in the patients with abnormal ECG was significantly higher than that of the normal group (P<0.05). The area under the receiver operating characteristic curve of the level of NT-proBNP on admission for predicting poor prognosis was 0.665, and its optimal cutoff value was 318.1 pg/ mL. Multivariate Logistic regression analysis showed that great than or equal to 318.1 pg/mL of serum NT-proBNP was an independent risk factor for poor prognosis in the patients with aSAH. Conclusion The level of serum NT-proBNP in the patients with aSAH on admission may be associated with the occurrence of neurocardiogenic injury, and its elevation may provide reference value for prediction of poor prognosis in aSAH patients.