老年急性脑梗死患者脑钠肽和同型半胱氨酸检测的临床意义

目的探讨脑钠肽(BNP)、同型半胱氨酸(Hcy)在老年急性脑梗死(ACI)中的水平及临床意义。方法随机选择老年急性脑梗死患者88例,健康对照组100例,测定各组BNP、Hcy水平,并进行比较。脑梗死患者按照病程分为急性期组(48例)和亚急性期组(40例);按照梗死面积大小分为大面积梗死(24例)、中面积梗死(29例)和小面积梗死(35例);按照病情程度分为重度(20例)、中度(3l例)、轻度(37例)。结果脑梗死患者急性期和亚急性期BNP和Hcy均有不同程度增高,具体为急性期>亚急性期>对照组,差异呈显著性(P<0.01);大面积脑梗死患者BNP、Hcy水平显著高于中、小面积脑梗死组(P<0.01),中面积脑梗死组血浆BNP、Hcy水平高于小面积脑梗死组(P<0.01);重度脑梗死组BNP、Hcy水平高于中、轻度脑梗死组(P<0.01),中度脑梗死组BNP、Hcy水平高于轻度脑梗死组(P<0.01)。结论急性脑梗死患者存在着BNP、Hcy水平的变化,并且与病程、病变范围和病情程度相关;二者联合检测可协助临床判断急性脑梗死的病情。

Clinical Significance of Brain Natriureticpeptide and Homocysteine Inold Patients with Acute Cerebral Infarction

Objective To investigate the changes of levels of brain natriuretic peptide （BNP） and homocysteine （Hcy） in old patients with acute cerebral infarction for evaluating their clinical signifi-cance.Methods 88 cases of old patients with acute cerebral infarction（ACI） were chosen and 100 cases of healthy persons wereas control for testing and comparing the 1 evels of BNP and Hcy.88 cases were divided intoacute cerebral infarction group （48 cases） and subacute cerebral infa-rction group（40 cases） by the course of disease.According to the extent of disease,they were divided into large infarction area（24 cases）,secondary infarction area（29 cases） and small infarction area（35 cases） groups.They were also divided into high-grade （20 cases）,middle-grade（31 cases） and low-grade（37 cases） groups in the light of the severity of disease.Results The levels of BNP and Hcy in patients with acute cerebral infarction and subacute cerebral infarction groups were significantly higher than those in control （P ＜0.01）.BNP and Hcy levels in patients with large infarction area were significantly higher than those in patients with secondary and small infarction area （P ＜0.01）,and the levels in patients with secondary infarction area were higher than those in small infarction area （p ＜ 0.01）.BNP and Hcy 1 evels in patients with high-grade group were higher than those in patients with middle-grade and low-grade groups（P ＜ 0.01）,and the 1 evels in patients with middle-grade were higher than those in low-grade groups （P ＜ 0.01）.Conclusion The levels of BNP and Hcy are changing with the course,extent,severity of disease in old patients with acute cerebral infarction.They have useful clinical values in ACI.