| 史丹丹,汪国爱.血清Fib与pro-BNP水平联合测定在老年HICH后发生脑水肿患者神经功能损伤中的预测价值[J].浙江中西医结合杂志,2018,28(4): |
| 血清Fib与pro-BNP水平联合测定在老年HICH后发生脑水肿患者神经功能损伤中的预测价值 |
| Predictive value of combined determination of serum pro-BNP and Fib levels of neurological impairment in elderly patients with cerebral edema after HICH |
| 投稿时间：2017-08-10 修订日期：2017-11-08 |
| DOI： |
| 中文关键词: 【关键词】老年人 高血压脑出血 脑水肿 Ｂ型钠尿肽前体 纤维蛋白原 |
| 英文关键词:【Key words】elderly hypertensive intracerebral hemorrhage cerebral edema pro-type B natriuretic peptide fibrinogen |
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| 中文摘要: |
| 【摘要】目的：分析血清纤维蛋白原（Fib）与Ｂ型钠尿肽前体（pro-BNP）水平联合测定在老年高血压脑出血（HICH）后发生脑水肿患者神经功能损伤中的预测价值。方法：选取本院90例老年HICH后发生脑水肿患者为病例组，并同期选择40例于本院体检健康的老年人为正常对照组。采用NHISS量表对两组进行评分，并通过ELISA法对两组血清Fib与pro-BNP水平进行测定。病例组患者均给予甘露醇治疗，记录患者治疗前后NHISS评分及血清Fib与pro-BNP水平情况，并通过ROC曲线分析联合测定血清Fib与pro-BNP水平在老年HICH后发生脑水肿患者神经功能损伤中的预测价值。结果：病例组治疗前NHISS评分及血清Fib与pro-BNP水平均显著较正常对照组高（均P>0.05）；治疗后1、3 d，病例组NHISS评分及血清Fib与pro-BNP水平均高于治疗前（均P<0.05），治疗后5、7、9时各指标均显著低于治疗前（均P<0.05）。ROC曲线分析结果发现，血清Fib与pro-BNP水平联合检测对预测老年HICH后发生脑水肿患者神经功能损伤中的敏感度、特异度及准确性均明显高于单独检测（均P<0.05）。结论：老年HICH后伴有脑水肿患者血清Fib与pro-BNP水平均明显升高，给予甘露醇治疗可明显减轻二者的水平，同时二者联合测定能够有效预测患者神经功能损伤的情况。 |
| 英文摘要: |
| [Abstract] Objective To analyze the predictive value of combined determination of serum fibrinogen (Fib) and pro- B type natriuretic peptide (pro-BNP) levels of neurological impairment in elderly cerebral edema after hypertensive intracerebral hemorrhage (HICH). Methods 90 elderly patients with cerebral edema after HICH were selected as the case group in our hospital, and 40 healthy elderly were selected as the control group at the same period. The two groups were scored by NHISS scale, and the serum Fib and pro-BNP levels were measured by ELISA method in the two groups. The case group were given mannitol treatment, and the NHISS score and serum Fib and pro-BNP levels were recorded before and after treatment, and combined determination of serum Fib and pro-BNP levels in the predictive value of neurological impairment in patients with cerebral edema after HICH was analyzed by ROC curve. Results The NHISS score and serum Fib and pro-BNP levels in the case group before treatment were significantly higher than those in the control group (all P>0.05); after treatment for 1, 3 days, the NHISS score and serum Fib and pro-BNP levels in the cases group were higher than those before treatment (all P <0.05), after treatment for 5, 7, 9 days, the NHISS score and serum Fib and pro-BNP levels were significant lower than those before treatment (all P <0.05). The results of ROC curve analysis showed that, compared with the single determination of serum Fib and pro-BNP levels, the sensitivity, specificity and accuracy for combined detection of serum Fib and pro-BNP to predict neurological damage were significantly increased in patients with cerebral edema after HICH (P<0.05). Conclusion The serum Fib and pro-BNP levels in elderly patients with cerebral edema after HICH were significantly elevated, giving mannitol therapy can significantly reduce the levels of two indexes, and the combined detection can effectively predict neurological damage. |
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