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目的:探讨血浆标志物水平在急性脑梗死和正常人群中的差异,并评估其与急性脑梗死的预后的关系;方法:纳入118例首发急性脑梗死患者和112名正常对照者,检测其血浆N端脑钠肽前体(NTproBNP)、D-二聚体(D-D)、同型半胱氨酸(HCY)的浓度。病例组临床神经功能损害程度采用美国国立卫生院神经功能缺损(NIHSS)评分,同时进行随访,观察各组的死亡、病残和复发性卒中事件。结果:急性脑梗死患者血浆NT-proBNP浓度明显高于对照组,差异具有统计学意义(P<0.05);病例组D-D浓度明显高于对照组,HCY浓度明显高于对照组,差异具有统计学意义(P<0.05);随访期间有11例(9.32%)死亡,15例(12.71%)病残,18例(15.25%)发生复发性卒中事件。血浆NT-proBNP、D-D、HCY与NIHSS评分之间明显正相关。多变量逻辑回归分析显示高龄、NIHSS评分、NT-proBNP、HCY均为预后不良的独立预测因素。结论:在急性脑梗死早期进行检测血浆标志物,如NT-proBNP、D-D、HCY,可以帮助判断病情的严重程度,其中NT-proBNP和HCY是预后不良的独立预测因素。
Abstract：Objective:To discuss the difference in plasma biomarkers between healthy people and patients with acute cerebral infarction,and to explore the value of plasma biomarkers in prognosis of patients with acute cerebral infarction.Methods:A total of 118 patients with first-ever acute cerebral infarction and 112 healthy controls were recruited and plama N-terminal pro-brain natriuretic peptide(NT-proBNP),D-dimer(D-D)and homocysteine(HCY)were tested.The neurological deficits in patients with cerebral infarction were evaluated by using National Institutes of Health Stroke Scale(NIHSS).Death,disablement and recurrent stroke events were followed up.Results:Plasma NT-proBNP levels in patients with acute cerebral infarction was significantly higher than those of healthy controls(373.4±112.3pg/mL vs.64.5±21.4pg/mL).Plasma D-D levels was significantly higher than those in healthy controls.Plasma HCY levels was significantly higher than those in healthy controls.11 patients(9.32%)died,15 patients(12.71%)disabled,and 18 patients(15.25%)had nonfatal recurrent stroke during the follow-up period.There was significant positive correlation between plasma NT-proBNP,D-D,HCY levels and NIHSS scores.Multivariate logistic regression analysis demonstrated that advanced age,NIHSS scores,NT-proBNP and HCY level were the independent predictors of poor outcome.Conclusions:The increased plasma biomarkers,such as NT-proBNP,D-D,HCY levels can be used to judge the severity of the disease,and NT-proBNP and HCY are the independent predictors in patients with acute cerebral infarction.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20141113.003
中图分类号:R743.3
引用信息:
[1]李博生,谢东玲,文国安.血浆标志物与急性脑梗死预后的关系[J].海南医学院学报,2015,21(02):256-258+261.DOI:10.13210/j.cnki.jhmu.20141113.003.
基金信息:
广东省新技术资助项目(gd281723)~~
2014-11-13
2014-11-13
2014-11-13