Study On The Levels Of N-terminal Pro-brain Natriuretic Peptide In Plasma In Patients With Acute Cerebral Infarction

Objective:To investigate the plasma levels of N-terminal Pro-brain NatriureticPeptide （NT-proBNP) changes and its clinical significance in patients with acute cerebralinfarction.Methods: The patients with acute cerebral infarction within48hours of onset as theobject of study (case group), according to the TOAST classification method for strokeetiological typing, and hospitalized patients with ischemic cerebral vascular disease ascontrol group. All patients in hospital with the United States national institutes of healthstroke scale score of neural function defect scale. NIHSS≥7points to serious neurologicaldeficit, NIHSS score <7points for minor neurological deficit. The case group and controlgroup patients are48hours of admission experts NT-proBNP assay, some patients duringhospitalization line color Doppler ultrasound and left ventricular function tests.Results: In347cases of cerebrovascular disease,237cases with acute cerebralinfarction patients,110cases of ischemic cerebrovascular disease. Cases in group ofpatients, average age70.94±12.04years old, male140cases (59.07%), female,97cases(40.93%), hypertension history151cases (151/237), diabetes67cases(67/237). AF showeda total of57people (57/237), including16cases did not provide a previous history of atrialfibrillation (16/57), dyslipidemia,111cases (111/237). Control group patients age71.70±11.08years old, male,58cases (52.73%),52cases (47.27%), hypertension69cases(69/110), diabetes22cases (22/110) in9cases of atrial fibrillation (9/110), dyslipidemia34cases (34/110). According to TOAST classification method,237cases of acute cerebralinfarction in patients with atherosclerosis cerebral infarction (Large-artery arthroscleroses,LAA)64cases, small vascular occlusive cerebral infarction (small-artery occlusion, SAO)60cases, cardiac cerebral embolism (cardioembolism, CE)54cases and cerebral infarction of other cause of59cases. Level of plasma NT-proBNP in case group is significantlyhigher than the control group (314.90pg/mlVS170.90pg/ml, P <0.001).Level of plasmaNT-proBNP in CE subgroups median2236.50pg/ml, CE with the NT-proBNPcomparison (LAA group155.10pg/ml, SAO group141.60pg/ml, other reasons,247.70pg/ml), its rise has significant statistical significance (P <0.001). Neurological deficitsevere cases, NT-proBNP levels in the case group admission560.60pg/ml, significantlyhigher than the level of minor neurological deficit of NT-proBNP (197.20pg/ml), thedifference was statistically significant (P <0.001); NT-proBNP in patients with death level(4491.10pg/ml) is significantly higher than survival {whether neural function defect inpatients with mild impairment (211.80pg/ml) or severe neuralgic deficits (421.10pg/ml,all P <0.001). The case and control groups of rows in cardiac structure ultrasound patientswere135(56.96%,135/237) and78(70.91%,78/110), cardiac function tests were126(53.16%126/237) and70(63.64%,70/110), ventricular sepal thickening is found in104cases (77.04%), left atrial diameter increase55(40.76%), left ventricular diastolic functionto reduce97people (79.51%), left ventricular systolic function, reduce the19people(15.08%). The factors influencing the NT-proBNP in addition to the stroke, age of thepatients (<65VS65or higher), atrial fibrillation (with VS without), hypertension (with VSwithout), diabetes (with VS without), cardiac structure and function (normal VS abnormal)are associated with it, in addition to high blood pressure, other factors between the twostates of the NT-proBNP level comparison, difference have statistical significance (P <0.05). The correlation analysis showed that NT-proBNP and cardiac ultrasound indicators:left atrial diameter, left ventricular systolic function, left ventricular diastolic functionindependently associated with NT-proBNP levels.Conclusion:1. Elevated levels of plasma NT-proBNP in patients with acute cerebralinfarction, patients with severe neuralgic deficits and death and CE plasma NT-proBNPlevels increased significantly. Patients with cerebral infarction early detection of plasmaNT-proBNP levels contribute to cerebral infarction etiology subtype diagnosis, especiallyCE diagnosis, in addition, contribute to the severity and prognosis of stroke patients.2. TheNT-proBNP levels are influenced by many factors, in addition to the stroke, age, atrialfibrillation, diabetes, interventricular septum thickness, left atrial diameter, left ventricularsystolic function and left ventricular diastolic dysfunction are associated with the NT-proBNP levels (P <0.05).