Relationships Between Bnp And Ct Findings And Clinical Prognosis In Patients With Acute Cerebral Injury

Objective:The relationship between the changes of brain natriuretic peptide (BNP) plasma concentration and the findings of head computed tomography (CT) and the clinical prognosis had been studied in the patients with acute cerebral injury, which was significant for judging the degree of cerebral injury and forecasting the prognosis more accurately and promptly, and making the suitable treatment for the patients.Methods:There were 41 hospitalized patients with acute cerebral injury and 41 healthy subjects for measuring BNP involved in this observation. The prognosis of the patients was evaluated as good or bad according to the standard method defined by Jennet and Bone. The brain swelling degrees in CT findings of the patients were divided into three types, slight, moderate and heavy ones, which was based on the morphological changes of the suprasellar cistern, ambient cistern and quadrigeminal cistern. The CT findings of the patients were classified as three types, typeⅠ,ⅡandⅢ, which was based on the degrees of the brain swelling and the middle line migration. A 4 ml blood sample of the patients was taken from the ulnar vein immediately as the patients were admitted to the hospital, and BNP plasma concentrations were detected via the chemical luminescent technique.Results:1.There was significant difference of the BNP plasma concentrations between 41 patients with acute cerebral injury and control ones (P<0.01)2.There were 23 patients accompanied by traumatic subarachniod hemorrhage (tSAH), and their BNP plasma concentration was significantly higher than that of the patients without tS AH (P<0.01) The rate of bad prognosis of the patients with tSAH accounted for 73.9%(17/23), significantly higher than that of the patients without tSAH(6/18) (P<0.01)3.The brain swelling (BS) was found in all the patients,12,12 and 17 patients defined as slight, moderate and heavy BS respectively. The BNP plasma concentration of the patients with heavy BS was significantly higher than that of the patients with slight BS (P<0.05),but not significantly higher than that of the patients with moderate BS (P>0.05).There was no significant difference of the BNP plasma concentrations between the patients with slight and moderate BS (P>0.05).The rate of bad prognosis was 33.3%(4/12),41.7%(5/12) and 82.4%(14/17) in the patients with slight, moderate and heavy BS respectively, and the rate of bad prognosis in the patients with heavy BS was significantly higher than that in the patients with slight and moderate BS (P<0.05).4.The CT findings of the patients were classified as three types, typeⅠseen in 13 cases, typeⅡin 14 ones and typeⅢin 14 ones too. The BNP plasma concentration of the typeⅢpatients was significantly higher than that of the typeⅠpatients (P<0.01),but not significantly higher than that of the typeⅡpatients (P>0.05).There was no significant difference of the BNP plasma concentrations between the typeⅠand typeⅡpatients (P>0.05). The rate of bad prognosis was 30.8%(4/13),57.1%(8/14) and 78.6%(11/14) in typeⅠ, typeⅡand typeⅢpatients respectively, and the rate of bad prognosis in typeⅢpatients was significantly higher than that in typeⅠpatients (P<0.05).Conclusion:The CT findings of the subarachnoid hemorrhage, the degree of the brain swelling, the category of CT findings and the BNP plasma concentration were important indexes for judging the degree of cerebral injury and the prognosis in the patients with acute cerebral injury, and the combination of them in clinical application was specially significant.