Alteration Of Plasma N-Terminal Pro-B-type Natriuretic Peptide And Its Relationship With Prognosis In Patients With Isolated Traumatic Brain Injury

Objective:To clear up whether the concentration of plasma N-terminal pro-brain natriuretie peptide(NT-pro BNP) is elevated in the early stage of traumatic brain injury(TBI).And to evaluate the value of NT-pro BNP in the assessment of the severity of TBI and the prognosis of TBI.Methods: From October 2013 to January 2015,69 TBI patients admitted to Itensive Care Unit of our hospital were studied.The control group contains 30 healthy people.By radioimmunoassay we determined the concentrations of the NT-pro BNP during the first96 hours and compared with the control group.We observed the dynamic change and evaluate the value of NT-pro BNP in the assessment of the severity of TBI and the prognosis of TBI.Results:1、On each time point after the disease comes on,the concentration of plasma Nt-pro BNP is obviously higher than the control group(P<0.05).And the NT-pro BNP concentration in the first 48 hours has a rising trend.2、With the deterioration of the illness,the levels of the the Nt-pro BNP present increasing in the early stage of TBI.The dynamic change of Nt-pro BNP of the three groups is different.The Nt-pro BNP levels of the first 72 hours in the severe TBI group have a rising trend,and the NT-pro BNP level of the 96 th hour doesn’t have an obvious declination compared with the 72 th hour(P>0.05);The levels of Nt-pro BNP in the moderate TBI group reach the peak on the48 th hour and then gradually decline;Besides,the Nt-pro BNP level of the 24 th hour in the mild TBI group have an obvious difference compared with control group(P<0.05).On each time point after the disease comes on,the plasma Nt-pro BNP level of the group with a poor prognosis is obviously higher than the group with a good prognosis(P<0.05).The dynamic change in levels of the boold Nt-pro BNP of the two groups is different.The concentration of the plasma Nt-pro BNP of the group with a poor prognosis has a rising trend in the first 48 hours,and then keeps the level till the 96 th hour( 910.33pg/m L±397.6pg/m L);The concentration of the group with a good prognosis reaches the peak(507.78pg/m L±290.5pg/m L)on the 48 th hour and then declines on the 96 th hour. 4、Among all the time points after the disease comes on,the Nt-pro BNP level of the 96 th hour is the best in predicting prognosis(AUC=0.952,95%CI[0.907-0.997]).The second is the level of the 72 th hour( AUC=0.933,95%CI[0.877-0.989]),and the worst is the level of the 48 th hour(AUC= 0.727,95%CI[0.606-0.848]).Conclusions:1 、 Levels of plasma Nt-pro BNP is elevated in the early stage of TBI.With the deterioration of the disease,the levels of plasma Nt-pro BNP will increase.2、Among the four time points,the plasma Nt-pro BNP of the 96 th hour is the best in predicting prognosis.It is will be helpful to judge the prognosis through measuring the levels.