大面积脑梗死患者亚急性期血清B型钠尿肽、D-二聚体及C反应蛋白与短期预后相关性研究

Relationship between serum B-type natriuretic peptide, D-dimer, C reactive protein and short-termprognosis in patients with massive cerebral infarction in subacute phase

  • 摘要:
      目的  探讨大面积脑梗死(MCI)亚急性期血清B型钠尿肽(BNP)、D-二聚体(D-D)及C反应蛋白(CRP)与短期预后的关系。
      方法  选取MCI患者137例,在常规治疗和护理基础上检测急性期血清BNP、D-D及CRP水平,并与健康体检者比较。根据MCI患者随访3个月时预后情况分为预后良好组和预后不良组,比较2组血清BNP、D-D及CRP水平。采用多因素Logistic回归分析和ROC曲线判断各指标对MCI患者短期预后的影响及预测价值。
      结果  MCI患者BNP、D-D及CRP水平显著高于健康体检者(P < 0.05); 137例MCI患者中预后不良者46例,预后良好组BNP、D-D及CRP水平均显著低于预后不良组(P < 0.05); Logistic回归分析结果显示,BNP、D-D及CRP均是影响MCI患者短期预后的重要因素(P < 0.05)。ROC曲线分析显示,BNP、D-D及CRP预测MCI短期预后的曲线下面积(AUC)分别为0.912、0.806和0.863,灵敏度分别为0.848、0.870和0.913,特异度分别为0.912、0.703和0.670。
      结论  BNP、D-D及CRP均是影响亚急性期MCI患者预后的重要因素,可用于监测病情进展,对于短期预后判断也具有较高临床价值。

     

    Abstract:
      Objective  To explore the relationship between serum B-type natriuretic peptide (BNP), D-dimer (D-D), C reactive protein (CRP) and short-term prognosis in patients with massive cerebral infarction (MCI) in subacute phase.
      Methods  Totally 137 MCI patients were selected and conducted detections of serum BNP, D-D and CRP in acute phase on the basis of routine treatment and nursing, and Results were compared with healthy controls. According to the condition of prognosis at 3 months of follow-up, the MCI patients were divided into good prognosis group and poor prognosis group, and the levels of serum BNP, D-D and CRP were compared between the two groups. Multivariate Logistic regression analysis and ROC curve were used to judge the effects and predictive value of each indicator on the short-term prognosis of MCI patients.
      Results  The levels of BNP, D-D and CRP in MCI patients were significantly higher than those in healthy controls (P < 0.05). Among the 137 MCI patients, there were 46 patients with poor prognosis, and the levels of BNP, D-D and CRP in good prognosis group were significantly lower than those in poor prognosis group (P < 0.05). Logistic regression analysis showed that BNP, D-D and CRP were important influencing factors for short-term prognosis of patients with MCI (P < 0.05). ROC curve analysis showed that the Area under the curve (AUC) values of BNP, D-D and CRP in predicting short-term prognosis of MCI were 0.912, 0.806 and 0.863 respectively, and the sensitivities were 0.848, 0.870 and 0.913, respectively, and the specificities were 0.912, 0.703 and 0.670, respectively.
      Conclusion  BNP, D-D and CRP are important influencing factors for prognosis of patients with MCI in subacute phase. These indexes can be used to monitor the progression of disease, and they show a high clinical value in the judgment of short-term prognosis.

     

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