急性缺血性脑卒中患者入院时血浆BNP水平与梗死部位关系

目的：分析急性缺血性脑卒中患者入院时血浆脑钠肽（BNP）水平与缺血性脑卒中梗死部位的关系。方法：随机入选88例急性缺血性脑卒中患者,按梗死部位,将其分为前循环病灶组（66名）和后循环病灶组（22名）两组进行比较。测定入院时血浆脑钠肽（BNP）水平进行比较。两组脑卒中病人的危险因素血糖、糖化血红蛋白、血脂全套,肝肾功能分析对比,并将急性缺血性脑卒中患者梗死部位相关的多个变量采用单因素logistic回归分析。结果：前循环病灶组血浆脑利钠肽水平的中位数是225.90 pg/mL,四分位数间距为596.00 pg/mL;后循环病灶组的中位数是750.95 pg/mL,四分位数间距为907.00 pg/mL。后循环病灶组血浆脑利钠肽水平要显著高于前循环病灶组血浆脑利钠肽水平,两个部位间入院时的脑利钠肽水平有统计学差异（P=0.004）。通过入院时脑利钠肽水平与缺血性脑卒中梗死部位的关系的ROC曲线,得出截点299.50 pg/mL。入院时血浆脑利钠肽水平≥299.50 pg/mL可以作为后循环病灶组的预测指标,其敏感性72.72%,特异性62.12%。结论：急性缺血性脑卒中患者入院时血浆BNP水平可作为急性期区别前后循环脑梗死的预测因子。

The Relationship between Plasma Brain Natriuretic Peptide Level on Admission and Infarction Location in Patients with Acute Ischemic Stroke

Objective： To analysis the relation between plasma brain natriuretic peptide （BNP） levels on admission and the infarction location in acute ischemic stroke patients. Methods： Randomly selected 88 acute ischemic stroke patients with acute phase of neurological deficit. The patients were divided into the anterior circulation infarction group and the posterior circulation infarction group. The plasma brain natriuretic peptide （BNP） levels on admission were compared.The risk factors, blood glucose, glycosylated hemoglobin, blood lipids, liver and kidney fimction of two groups complete comparative analysis. And a number of variables related to the position in patients with acute ischemic stroke are analysis with the single factor Logistic regression. Results： The median of anterior circulation lesion group of plasma brain natriuretic peptide level is 225.90 pg/mL, The four quantile interval is 596.00 pg/mL, The median of posterior circulation lesion group of plasma brain natriuretic peptide level is 750.95 pg/mL, The four quantile interval is 907.00 pg/mL. The plasma BNP levels on admission in the posterior group were significantly higher than in the anterior group （P=0.004）. The ROC curves of admission of brain natriuretic peptide level in patients with cerebral ischemic stroke infarcts shows that section is 299.50 pg/mL. The brain natriuretic peptide levels ≥ plasma 299.50 pg/mL on admission may be viewed as a predictive factor of posterior circulation lesions, the sensitivity was 72.72%, specificity 62.12%. Conculusion： Plasma BNP levels on admission can be viewed as a predictive factor of anterior circulation infarction or the posterior circulation infarction of acute ischemic stroke patients.