血浆B型脑钠肽前体和D-二聚体水平对急性脑梗死预后的影响

目的探讨急性脑梗死患者血浆B型脑钠肽前体(NT-proBNP)和D-二聚体水平对预后的影响。方法采用前瞻性对照研究。急性脑梗死组50例,为发病24h内住院的脑梗死患者;对照组20例,为本院同期的非脑血管疾病患者。观察指标:入院时血浆NT-proBNP和D-二聚体水平;患者一般情况;脑梗死面积;NIHSS评分;随访3个月时的预后。结果脑梗死组入院时血浆NT-proBNP和D-二聚体水平显著高于对照组(P<0.05);大面积脑梗死组NT-proBNP和D-二聚体水平显著高于非大面积脑梗死组(P<0.0 5)。有意识障碍者和高血压组血浆NT-proBNP和D-二聚体水平明显高于无意识障碍和正常血压组。随访3个月时,10例死亡,死亡组血浆NT-proB-NP和D-二聚体水平高于存活组。结论急性脑梗死后血浆NT-proBNP和D-二聚体水平增高。梗死面积越大,血浆NT-proBNP和D-二聚体水平越高,脑梗死预后越差。因此,血浆NT-proBNP和D-二聚体水平有可能成为监测脑梗死患者病情变化和预测预后的重要及快捷的指标之一。

Relationship between N-terminal proBNP,NT-proBNP (NT-proBNP) ,D-Dimer and the prognosis in patients with acute cerebral infarction

Objective To explore the relationship between N-terminal proBNP,NT-proBNP(NT-proBNP),D-Dimer and the prognosis in patients with acute cerebral infarction.Methods A prospective control study was used.There were 50 patients in the acute cerebral infarction group,who were in hospital within 24h after onset,and 20 cases in the healthy control group.The plasma level of NT-proBNP and D-Dimer on admission,general conditions,size of infarction,National Institute of Health stroke scale(NIHSS),and prognosis of follow-up for three month were observed.Results The plasma levels of NT-proBNP and D-dimer were significantly higher in the acute cerebral infarction group than in control(P<0.05).Its were significantly higher in patients with massive cerebral infarction or disturbance of consciousness or hypertension than in patients without the conditions(P<0.05).After following-up for 3 months,death was observed in 10 patients.The plasma levels of NT-proBNP and D-dimer were higher in the death group than the improved group.Conclusion The plasma levels of NT-proBNP and D-dimer were increased after acute cerebral infarction.The greater the infarct size was,the higher the plasma levels of NT-proBNP and D-dimer were,the worse the prognosis was.Therefore,the plasma levels of NT-proBNP and D-dimer may become one of the important and quick indexes to monitor the changes of condition and predict prognosis in patients with acute cerebral infarction.