N 末端脑钠肽前体及 D-二聚体水平变化对急性脑梗死神经功能缺损及出血转化风险的临床意义∗

摘要

目的：：分析血 N末端脑钠肽前体(NT-proBNP)及 D-二聚体水平在老年急性脑梗死神经功能缺损及出血转化患者中的变化和意义。方法：急性脑梗死老年患者123例(脑梗死组),根据 NIHSS 评分将其分为轻型、中型、重型三个亚组；又依据发病7-10天后头部 MRI 结果将其分为出血转化和未出血转化两个亚组。另选体检健康人群86例作为对照组,检测各组和各亚组受试者血清 NT-proBNP 和血浆 D-二聚体水平。比较各组和各亚组之间两指标水平差异。结果：脑梗死组 NT-proBNP 和 D-二聚体水平均明显高于对照组(P <0.01)；且中、重型组高于轻型组(P <0.01),重型组高于中型组(P <0.01)。出血转化组 D-二聚体水平明显高于未出血转化组(P <0.01),NT-proBNP 水平在出血转化和未出血转化组间的差异无统计学意义(P >0.05)。结论：NT-proBNP 和 D-二聚体水平升高对分析老年急性脑梗死患者神经功能缺损程度及出血转化风险有重要临床意义。%Objective:To analyze the changes and clinical significance of NT-proBNP and D-dimer in neurolog-ic impairment and hemorrhagic transformation risk in elderly patients with acute cerebral infarction.Method:123 elderly patients with acute cerebral infarction were selected as cerebral infarction group,86 cases with health exami-nation as control group.The levels of serum NT-proBNP and plasma D-dimer in each group were detected.The cer-ebral infarction group was diveded into light,medium and heavy subgroup according to NIHSS scoring method,and was diveded into hemorrhagic transformation(HT)group and non hemorrhagic transformation(NHT)group accord-ing to head MRI results of 7-10 days after the onset of the disease.The levels of the two indicators between different groups and subgroups were compared.Results:In cerebral infarction group,the levels of NT-proBNP and D-dimer were both significantly higher than those in control group (P <0.01),and the medium and heavy subgroup were higher than those in light subgroup(P <0.01),and the heavy subgroup were higher than in medium subgroup(P <0.01).The level of D-dimer in HT group was significantly higher than that in NHT group(P <0.01).The differ-ence of the level of NT-proBNP between the two subgroups had no statistical significance(P >0.05 ).Conclusion:The increased NT-proBNP and D-dimer levels have an important clinical significance to analyze neurologic impair-ment and hemorrhagic transformation risk in elderly patients with acute cerebral infarction.