Study On The Changes Of Plasma Levels Of Copeptin And N-terminalpro-B-type Natriuretic Peptide In Patients With Acute Cerebral Infarction

Objective1)To observe the changes in patients with acute cerebral infarction(ACI) inacutephase serum copeptin,N-terminal brain natriuretic peptide(NT-proBNP)levels.2)To investigate the relationship between serum copeptin,NT-proBNP levelsinpatients with ACI in acute stage of the disease assessment and prognosis.Methods1)86cases of ACI patients were treated as the object of study, which werediagnosed China ischemic stroke treatment guidelines in2010, and by head CT or MRIshowed. Including male51cases, female35cases, age51-76years old, mean aged(62.5±9.6)years; Select the hospital medical center50healthy persons as control group,including32cases of male, female18cases, mean age (59.4±7.2) years.2)In ACIgroup， the Routine blood test, Liver function, renal function, Fasting plasmaglucose(FPG),Blood lipid, Myocardial enzymes, Electrolyte, Homocysteine(HCY),Fibrinogen (FIB), HbA1c and C-reactive protein (CRP) were measured; score of theNational Institutes of Health Stroke Scale(NIHSS) were assessed. According to thescore of NIHSS group patients: NIHSS <7were divided into mild group, NIHSS≥7points for the severe group. Patients with24h,7d,14d and serum copeptin, NT-proBNPlevels were measured, and compared with control group. Comparison of mild group andsevere group24h,7d,14d, serum copeptin, NT-proBNP level. To follow up all patientsafter the onset of90d,by using the modified Rankin Scale (mRS) score impairedneurological outcome, MRS≤2divided into good prognosis group,≥3to the poorprognosis group;24h serum copeptin, NT-proBNP levels were compared between thetwo groups; the influence of plasma copeptin,NT-proBNP level on the prognosis of ACIpatients were analyzed．Results1)All86patients with ACI serum24h copeptin, NTpro-BNP levels weresignificantly higher than that of the control group, the difference was statistically significant (P <0.01);the24h,7d,14d serum copeptin, NTpro-BNP levels of the severegroup were significantly higher in mild group, the difference was statistically significant(P <0.05);The poor prognosis group24h serum copeptin, NTpro-BNP levels weresignificantly higher than that of the good outcome group, the difference was statisticallysignificant (P <0.01).2)Correlation of ACI on serum copeptin, NT-proBNP levels werepositively correlated with NIHSS score，Severe group correlation coefficients (r=0.631,r=0.524, P <0.01),the correlation coefficient in mild group respectively (r=0.572,r=0.512, P <0.01).3)Single factor Logistic regression analysis showed,Age, CRP,NIHSS, copeptin, NT-proBNP levels for the factors affecting the prognosis of acutecerebral infarction (P <0.05),Multivariate Logistic regression analysis showed,the levelof serum copeptin, NIHSS score were independent prognostic indicators of ACI.Conclusions:1)Serum copeptin, NTpro-BNP levels in patients with acute cerebralinfarction were significantly higher;2)24h serum copeptin, NT-proBNP levels weresignificantly positive correlation with the neurological severity and prognosis.It isimportant to assess the condition judgment in patients with ACI and prognosis.