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目的观察老年脑梗死(cerebral infarction,CI)患者血浆中B型脑钠肽(brain natriuretic peptide,BNP)水平的变化特征,探讨BNP在CI中的临床应用意义。方法选择60例老年CI患者为观察组,58名体检健康者为对照组;60例CI患者依据病程将CI分为急性期(发病3d内)亚组和亚急性期(发病3~10 d)亚组;60例CI患者根据头颅MRI分型将脑梗死为大面积脑梗死(病灶直径>5 cm)亚组和非大面积脑梗死(病灶直径≤5 cm)亚组。检测各组和亚组血浆中的BNP水平与进行比较分析。结果 CI组血浆BNP水平显著高于对照组(P<0.01);CI组急性期亚组血浆BNP含量明显高于对照组(P<0.01),也显著高于亚急性期亚组(P<0.01);大面积CI亚组血浆BNP含量显著高于非大面积CI亚组(P<0.01)。结论急性期和大面积CI老年患者血浆BNP水平明显升高,提示BNP可能在老年CI发生过程中起着重要作用,可望成为CI诊断指标。
Objective To observe the changes of plasma BNP level in elderly patients with cerebral infarction (CI) and to explore the clinical significance of BNP in CI. Methods Sixty elderly CI patients were selected as observation group and 58 healthy control subjects as control group. According to the course of CI, 60 CI patients were divided into subgroups of acute phase (within 3 days of onset) and subacute phase (onset of 3 to 10 days) Subgroups; 60 patients with CI under the head MRI classification of cerebral infarction for large cerebral infarction (lesion diameter> 5 cm) subgroup and non-large area cerebral infarction (lesion diameter ≤ 5 cm) subgroup. BNP levels in each group and subgroup were measured and compared. Results Plasma BNP level in CI group was significantly higher than that in control group (P <0.01). Plasma BNP level in CI group was significantly higher than that in control group (P <0.01), and significantly higher than that in sub-acute phase group ). Plasma BNP level in the large CI subgroup was significantly higher than that in the non-large CI subgroup (P <0.01). Conclusions Plasma BNP levels are significantly elevated in elderly patients with acute CI and in large-area CI patients, suggesting that BNP may play an important role in the pathogenesis of CI and may become a diagnostic index for CI.