上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (9): 1065-.doi: 10.3969/j.issn.1674-8115.2019.09.020

• 论著·临床研究 • 上一篇    下一篇

血浆脑钠肽水平与急性缺血性卒中静脉溶栓患者功能预后的关系

庄美婷，何欣威 ，赵蓉，尹家文，胡玥，刘建仁   

  1. 上海交通大学医学院附属第九人民医院神经内科，上海 200011
  • 出版日期:2019-09-28 发布日期:2019-11-02
  • 通讯作者: 刘建仁，电子信箱：liujr021@sjtu.edu.cn。何欣威，电子信箱：doctorxinweihe@163.com。为共同通信作者。
  • 作者简介:庄美婷（1992—），女，硕士生；电子信箱： may_z2015@163.com。
  • 基金资助:
    上海市教育委员会高峰高原学科建设计划（20161422）；上海交通大学医学院临床研究项目（DLY201614）；上海市医院发展中心慢病防治项目 （SHDC12015310）

Correlation between plasma brain natriuretic peptide and functional outcome after intravenous thrombolysis in patients with acute ischemic stroke

ZHUANG Mei-ting, HE Xin-wei, ZHAO Rong, YIN Jia-wen, HU Yue, LIU Jian-ren   

  1. Department of Neurology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University, Shanghai 200011, China
  • Online:2019-09-28 Published:2019-11-02
  • Supported by:
    Shanghai Municipal Education Commission— Gaofeng Clinical Medicine Support, 20161422; Clinical Research Project of Shanghai Jiao Tong University School of Medicine, DLY201614; Chronic Disease Prevention and Treatment Project of Shanghai Hospital Development Center, SHDC12015310）。

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摘要： 目的 ·探讨 rt-PA静脉溶栓后缺血性卒中患者血浆脑钠肽 (brain natriuretic peptide，BNP) 水平与功能预后的相关性及其临床意义。方法 ·分析 141例接受单纯静脉溶栓的急性缺血性卒中患者的临床资料；根据溶栓后 3个月改良 Rankin量表（ modified Rankin Scale，mRS）评分，分为良好预后组（ mRS ≤ 1分）和不良预后组（ mRS>1分），组间比较溶栓后 BNP水平；通过受试者工作特征曲线（ receiver operator characteristic curve，ROC曲线）分析 BNP水平对溶栓后 3个月功能预后的预测能力，并通过 Logistic回归分析校正其他相关因素的影响。结果 ·与良好预后组相比，不良预后组的 BNP水平明显升高（ P0.003）；ROC曲线分析结果显示，溶栓后升高的 BNP水平（ BNP>202.6 pg/mL）对接受静脉溶栓的急性缺血性卒中患者的 3个月不良功能预后具有一定的预测能力；通过 Logistic回归分析校正相关因素后，发现升高的 BNP水平仍是接受静脉溶栓的急性缺血性卒中患者 3个月不良功能预后的独立预测因素（ OR2.406，95% CI为 1.069～ 5.417，P0.034）。结论 ·溶栓后血浆 BNP水平与溶栓后 3个月不良功能预后相关，升高的 BNP水平对接受静脉溶栓的急性缺血性卒中患者 3个月不良功能预后具有一定的预测价值。

关键词: 缺血性卒中, 静脉溶栓, 脑钠肽

Abstract:

Objective · To study the correlation between brain natriuretic peptide (BNP) in plasma and functional outcome in patients with acute ischemic stroke after intravenous thrombolysis and its clinical significance. Methods · An analysis was performed on 141 cases of acute ischemic stroke patients with intravenous thrombolysis. According to the modified Rankin Scale (mRS) 3 months after thrombolysis, the patients were divided into the good outcome group (mRS ≤ 1) and the poor outcome group (mRS>1). BNP level indicators after thrombolysis were compared between the two groups. The receiver operator characteristic (ROC) curve was used to analyze the ability of BNP level to predict the functional outcome 3 months after thrombolysis, and the influence of some other relevant factors was adjustedLogistic regression analysis. Results · Compared with the good outcome group, the level of BNP in the poor outcome group was significantly increased (P0.003). According to ROC curve analysis, the elevated BNP level (BNP>202.6 pg/mL) had a certain predictive ability for poor functional outcome 3 months after intravenous thrombolysis in patients with acute ischemic stroke. Elevated BNP level was an independent predictor of functional outcome 3 months after intravenous thrombolysis in patients with acute ischemic stroke (OR2.406, 95% CI 1.0695.417, P0.034). Conclusion · Elevated plasma BNP level after thrombolysis is significantly associated with poor functional outcome in patients with acute ischemic stroke after intravenous thrombolysis, suggesting a predictive role of BNP for poor outcome 3 months after intravenous thrombolysis.

Key words: acute ischemic stroke, intravenous thrombolysis, brain natriuretic peptide

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