【摘要】：目的:分析急性腦梗死(Acute Cerebral Infarction,ACI)患者血漿N端腦鈉肽前體(N terminal pro brain natriuretic peptide,NT-pro BNP)的病理變化及與不同梗死面積、梗死部位、頸動脈粥樣硬化(Carotid artery atherosclerosis,CAA)、神經(jīng)功能缺損程度及預(yù)后的相關(guān)性。方法:將發(fā)病24小時(shí)內(nèi)的90例急性腦梗死患者作為病例組(研究對象來自于2015年2月至2016年9月在蚌埠醫(yī)學(xué)院第二附屬醫(yī)院神經(jīng)內(nèi)科住院患者),同期健康體檢者40例為對照組。檢驗(yàn)并比較病例組入院24h、治療7天、治療14天血漿NT-pro BNP水平及對照組入選當(dāng)日清晨血漿NT-pro BNP水平,病例組依照頭顱MRI結(jié)果按照梗死面積、梗死部位比較入院24h、治療7天、治療14天血漿NT-pro BNP水平;應(yīng)用彩色多普勒超聲檢測病例組頸動脈內(nèi)膜中層厚度(intima media thickness,IMT)并與入院24 h血漿NT-pro BNP水平比較;通過采用美國國立衛(wèi)生研究院卒中量表(the national institutes of health stroke scale,NIHSS)對入院時(shí)病例組患者的神經(jīng)功能缺損程度進(jìn)行分組并與入院24 h血漿NT-pro BNP水平比較并追蹤預(yù)后。結(jié)果:病例組患者血漿NT-pro BNP水平明顯高于對照組(t=16.840,P=0.00),入院24 h血漿NT-pro BNP水平最高,后逐漸下降,2周時(shí)最低;重癥亞組入院24h血漿NT-pro BNP水平明顯高于輕癥亞組,輕癥亞組高于健康對照組(F值=102.386,P=0.00),且預(yù)后漸好轉(zhuǎn);大面積腦梗死亞組入院24 h、第7天、第14天血漿NT-pro BNP水平明顯高于中面積腦梗死亞組,中面積腦梗死亞組血漿NT-pro BNP水平明顯高于小面積腦梗死亞組(F值=188.694、200.641、181.731,P均=0.00);前、后循環(huán)腦梗死血漿NT-pro BNP水平比較差異無統(tǒng)計(jì)學(xué)意義(F值=0.000,P0.05);且梗死組入院24h血漿NT-pro BNP水平與NIHSS、IMT呈正相關(guān)(r=0.692、0.672,P均=0.00)。結(jié)論:急性期時(shí),腦梗死患者血漿NT-pro BNP水平有明顯升高,梗死面積越大,升高越明顯,但與梗死部位并無相關(guān)性,患者血漿NT-pro BNP水平在預(yù)測頸動脈粥樣硬化危險(xiǎn)性上具有重要意義,其在預(yù)測可能病程和結(jié)局中也具有重要的參考價(jià)值。作為動態(tài)監(jiān)測急性腦梗死患者血清學(xué)的重要指標(biāo),入院24h血漿NT-pro BNP水平聯(lián)合NIHSS評分可以更加充分有力地對急性腦梗死嚴(yán)重程度和疾病的發(fā)展情況進(jìn)行分析和預(yù)測。
[Abstract]:Objective: to analyze the pathological changes of plasma N-terminal brain natriuretic peptide precursor (N terminal pro brain natriuretic peptide,NT-pro BNP (N terminal pro brain natriuretic peptide,NT-pro BNP) in patients with acute cerebral infarction (Acute Cerebral Infarction,ACI) and its relationship with different infarction area, infarction site and carotid atherosclerosis (Carotid artery atherosclerosis,CAA). Correlation between the degree of neurological deficit and prognosis. Methods: 90 patients with acute cerebral infarction within 24 hours were selected as the case group (the subjects were hospitalized in the Department of Neurology, the second affiliated Hospital of Bengbu Medical College from February 2015 to September 2016). At the same time, 40 cases of healthy physical examination were taken as the control group. The plasma NT-pro BNP level of the case group was tested and compared with that of the control group on the morning of the day of admission for 24 hours, 7 days of treatment, 14 days of treatment and 24 hours of admission according to the size of infarction and the location of infarction in the case group according to the MRI results of the head. The plasma NT-pro BNP level was 7 days and 14 days after treatment. The carotid intima-media thickness (intima media thickness,IMT) in the case group was measured by color Doppler ultrasound and the plasma NT-pro BNP level was compared with that at 24 hours after admission. The neurological deficit degree of the patients in the admission group was divided into two groups by using the National Institutes of Health Stroke scale (the national institutes of health stroke scale,NIHSS) and compared with the plasma NT-pro BNP level at 24 hours after admission and the prognosis was followed up. Results: the plasma NT-pro BNP level in the case group was significantly higher than that in the control group (t = 16.840, P 鈮，

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