中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2011年
6期
446-448
,共3页
利钠肽,脑%颅脑损伤
利鈉肽,腦%顱腦損傷
리납태,뇌%로뇌손상
Natriuretic peptide,brain%Craniocerebral trauma
目的 研究N末端B型利钠肽(NT-proBNP)在老年重型脑功能损伤患者急性期变化临床规律、临床意义及可能的影响因素.方法 观察严重的颅脑功能损伤患者发病第1、3、5、7天NT-proBNP及心肌肌钙蛋白I(cTn-I)的变化规律,分析颅脑功能损伤致急性神经功能障碍与NT-proBNP、cTn-I,变化的相关性及其对预后的影响.结果 死亡组各时点的NT-proBNP在住院第3、5、7天[(759±341)、(1980±839)、(2490±1862)ng/L]明显高于存活组[(594±612)、(733±424)、(315±346)ng/L];两组患者的cTn-I及NT-proBNP升高与进行性加重的颅内水肿相关;死亡组与存活组在早期颅内损伤病灶分布区有明显差别,死亡组基底节、脑干分布区高于存活组;7 d后NT-proBNP仍处于较高水平者提示预后不良;NT-proBNP 的升高与cTn-I水平无相关性(r=0.0214,P＞0.05).结论 老年严重颅脑功能损伤患者急性期NT-proBNP进行性升高提示预后不良;老年严重颅脑功能损伤患者急性期其NT-proBNP升高幅度与颅脑损伤功能区有相关性.
目的 研究N末耑B型利鈉肽(NT-proBNP)在老年重型腦功能損傷患者急性期變化臨床規律、臨床意義及可能的影響因素.方法 觀察嚴重的顱腦功能損傷患者髮病第1、3、5、7天NT-proBNP及心肌肌鈣蛋白I(cTn-I)的變化規律,分析顱腦功能損傷緻急性神經功能障礙與NT-proBNP、cTn-I,變化的相關性及其對預後的影響.結果 死亡組各時點的NT-proBNP在住院第3、5、7天[(759±341)、(1980±839)、(2490±1862)ng/L]明顯高于存活組[(594±612)、(733±424)、(315±346)ng/L];兩組患者的cTn-I及NT-proBNP升高與進行性加重的顱內水腫相關;死亡組與存活組在早期顱內損傷病竈分佈區有明顯差彆,死亡組基底節、腦榦分佈區高于存活組;7 d後NT-proBNP仍處于較高水平者提示預後不良;NT-proBNP 的升高與cTn-I水平無相關性(r=0.0214,P＞0.05).結論 老年嚴重顱腦功能損傷患者急性期NT-proBNP進行性升高提示預後不良;老年嚴重顱腦功能損傷患者急性期其NT-proBNP升高幅度與顱腦損傷功能區有相關性.
목적 연구N말단B형리납태(NT-proBNP)재노년중형뇌공능손상환자급성기변화림상규률、림상의의급가능적영향인소.방법 관찰엄중적로뇌공능손상환자발병제1、3、5、7천NT-proBNP급심기기개단백I(cTn-I)적변화규률,분석로뇌공능손상치급성신경공능장애여NT-proBNP、cTn-I,변화적상관성급기대예후적영향.결과 사망조각시점적NT-proBNP재주원제3、5、7천[(759±341)、(1980±839)、(2490±1862)ng/L]명현고우존활조[(594±612)、(733±424)、(315±346)ng/L];량조환자적cTn-I급NT-proBNP승고여진행성가중적로내수종상관;사망조여존활조재조기로내손상병조분포구유명현차별,사망조기저절、뇌간분포구고우존활조;7 d후NT-proBNP잉처우교고수평자제시예후불량;NT-proBNP 적승고여cTn-I수평무상관성(r=0.0214,P＞0.05).결론 노년엄중로뇌공능손상환자급성기NT-proBNP진행성승고제시예후불량;노년엄중로뇌공능손상환자급성기기NT-proBNP승고폭도여로뇌손상공능구유상관성.
Objective To explore the changes and influencing factors of serum NT-proBNP level in aged patients with severe brain dysfunction in acute phase, and the corresponding clinical significance. Methods The serum NT-proBNP and cTn-I levels of patients with severe brain dysfunction at day 1, 3, 5 and 7 were measured respectively. The correlation between acute neurological dysfunction caused by brain dysfunction and serum NT-proBNP and cTn-I levels were analyzed, and the impact on prognosis was explored. Results The serum NT-proBNP levels were significantly higher in death group at day 3[(759±341)ng/L], 5[(1980±839)ng/L] and 7[(2490±1862)ng/L] than in survival group[(594±612)ng/L,(733±424)ng/L,(315±346)ng/L]. Serum NT-proBNP and cTnI levels were associated with progressive cerebral edema in both groups. Location of early intracranial lesions was significantly different between two groups. Death group had higher ratio of intracranial lesions in basal ganglia and brainstem than did survival group. High serum NT-proBNP level after day 7 suggested poor prognosis. Serum NT-proBNP level was not associated with serum cTn-I level. Conclusions Progressively increased serum NT-proBNP level in aged patients with severe brain dysfunction in acute phase suggests poor prognosis. The increased degree of serum NT-proBNP in aged patients with severe brain dysfunction in acute phase is associated with the location of intracranial lesions.
