Correlation Between Blood BNP And Clinical Prognosis In Patients With Cerebral Infarction Treated By Rt-PA Intravenous Thrombolysis

Objective : Recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis is the first choice for acute cerebral infarction.However,the clinical prognosis of patients with intravenous thrombolysis varies greatly,and there are no specific indicators to predict the prognosis.Brain natriuretic peptide(BNP)is closely related to acute cerebral infarction.Combined with the existing single-center small sample study,it is suggested that the increased BNP may be related to the early recanalization of blood vessels after intravenous thrombolytic therapy.Could BNP play a predictive role in intravenous thrombolytic patients? Can BNP be a biological indicator for judging the prognosis of patients with intravenous thrombolysis? Therefore,we want to determine that BNP can be a reliable indicator for predicting clinical prognosis of thrombolytic patients by further research.Thereby avoiding the risk of intravenous thrombolysis in patients with cerebral infarction,and better guiding clinical diagnosis and treatment.Method:According to the inclusion and exclusion criteria,200 patients with acute cerebral infarction who underwent rt-PA intravenous thrombolysis in the Department of Neurology and Emergency Department of Yantai Yuhuangding Hospital affiliated to Qingdao University from 2017.09 to 2018.10 were included.Collecting BNP levels and blood routine before rt-PA intravenous thrombolytic therapy in patients with acute cerebral infarction.At the same time,the biochemical parameters of the blood(between 5 and 6 am)of the patients on the second day of hospitalization were collected.Collecting patients’ cardiac EF,valvular disease,cerebral vascular stenosis,atrial fibrillation.The patient’s basic demographic parameters and basic data were collected,including age,gender,hypertension,diabetes,previous history of cerebral infarction,history of coronary heart disease,history of alcohol abuse,history of smoking,and blood pressure at admission.The National Institute of Health Stroke Scale(NIHSS)was used to evaluate the severity of patients with acute cerebral infarction.The prognosis of patients with acute cerebral infarction was obtained by a modified Rankin Scale(MRS)score at 3 months.The MRS<3 was a good prognosis,MRS≥3 was a poor prognosis.The patients’ clinical characteristics were statistically described,and the continuity test was performed on the continuous data using the Explore test.Continuity variables that conform to a normal distribution are described by mean±standard deviation,and continuous variables that do not conform to a normal distribution are described by a median(interquartile range),and categorical variables are represented by a composition ratio.We used the Jonckheere-Terpstra test to evaluate trends between BNP values and poor prognosis.Correlation between blood BNP values and clinical prognosis in patients with acute cerebral infarction by intravenous thrombolysis was analyzed by a two-class logistic regression model.All statistics were performed on SPSS 24.0 software.Result:The total number of study cohorts is ranked from small to large according to BNP values.Approximate three equal parts are divided into three groups: low,medium and high.Contains 67,72,and 61 patients,respectively.In the low BNP group(median BNP of 13.61,25th-75 th spacing of 10-22.62),the incidence of adverse prognosis was 35.8%;In the middle BNP group(median BNP of 63.95,25th-75 th interval 46.63-88.53),the incidence of adverse prognosis was 38.9%;In the high BNP group(median BNP 276.8,25th-75 th spacing 192.13-580.97),the adverse prognosis rate was 55.7%.After Jonckheere-Terpstra test,there was a statistically significant difference between the three groups(P<0.05).Two-class logistic regression analysis revealed high plasma BNP,valvular heart disease and previous history of cerebral infarction and acute cerebral infarction.The poor prognosis was significantly correlated at month(P<0.05).Conclusion:In this study,we found that BNP was significantly associated with prognosis at 3 months in patients with acute cerebral infarction.High plasma BNP suggested poor prognosis in patients with acute cerebral infarction.