本文選題：腦梗死 + 心房顫動(dòng)　； 參考：《上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年01期

【摘要】：目的·探討B(tài)型鈉尿肽(BNP)對(duì)心房顫動(dòng)合并腦梗死急性期抗栓治療選擇的意義。方法·回顧性分析714例急性腦梗死合并心房顫動(dòng)患者的臨床資料。以BNP=912.5 pg/m L(第95分位數(shù))為分界值,將患者分成2組,每組再根據(jù)不同的抗栓治療,分為抗血小板組和抗凝組。比較入院時(shí)和治療后21 d 2組患者的美國(guó)國(guó)立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分和改良的Rankin量表(m RS)評(píng)分,同時(shí)比較2組顱內(nèi)出血、癥狀性顱內(nèi)出血、消化道出血、腦梗死再發(fā)、深靜脈血栓發(fā)生率及病死率。結(jié)果·對(duì)于BNP912.5 pg/m L的患者,抗凝治療組的NIHSS評(píng)分(P=0.015)及m RS評(píng)分(P=0.031)改善比顯著高于抗血小板治療組;抗血小板治療組病死率和腦梗死再發(fā)率高于抗凝治療組,但差異無(wú)統(tǒng)計(jì)學(xué)意義;兩治療組所有出血、顱內(nèi)出血、癥狀性顱內(nèi)出血、消化道出血、深靜脈血栓發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義。對(duì)于BNP≤912.5 pg/m L的患者,兩治療組之間NIHSS評(píng)分及m RS評(píng)分改善比的差異無(wú)統(tǒng)計(jì)學(xué)意義;抗血小板治療組病死率和腦梗死再發(fā)率高于抗凝治療組,但差異無(wú)統(tǒng)計(jì)學(xué)意義;兩治療組所有出血、顱內(nèi)出血、癥狀性顱內(nèi)出血、消化道出血、深靜脈血栓發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論·BNP912.5 pg/m L的心房顫動(dòng)合并腦梗死急性期患者采用抗凝治療,其療效可能優(yōu)于抗血小板治療。
[Abstract]:Objective to investigate the significance of B type natriuretic peptide (BNP) in the treatment of atrial fibrillation with acute cerebral infarction.Methods the clinical data of 714 patients with acute cerebral infarction complicated with atrial fibrillation were retrospectively analyzed.The patients were divided into two groups by BNP=912.5 pg/m L (95 quartile). Each group was divided into antiplatelet group and anticoagulant group according to different antithrombotic therapy.The scores of NIHSS and modified Rankin scale were compared between the two groups on admission and 21 days after treatment. At the same time, intracranial hemorrhage, symptomatic intracranial hemorrhage, gastrointestinal hemorrhage and recurrent cerebral infarction were compared between the two groups.Incidence and mortality of deep venous thrombosis.Results for the patients with BNP912.5 pg/m L, the improvement ratio of NIHSS score (P0.015) and Mrs score (P0.031) in the anticoagulant treatment group was significantly higher than that in the antiplatelet treatment group, and the mortality and the recurrence rate of cerebral infarction in the antiplatelet treatment group were higher than those in the anticoagulant treatment group.There was no significant difference in the incidence of hemorrhage, intracranial hemorrhage, symptomatic intracranial hemorrhage, gastrointestinal hemorrhage and deep venous thrombosis between the two groups.For patients with BNP 鈮，

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