| Objective: To investigate the related factors of serum amino acid type B natriuretic peptide(NT-pro BNP)levels in patients with acute cerebral infarctionand clinical predictive value.Methods: 92 patients with acute cerebral infarction in our hospital from February 2016 to December 2017 were selected in the study.Inclusion criteria:Acute cerebral infarction confirmed by clinical,CT or MRI;Initial onset and admission within 24 hours;The clinical data are complete.Exclusion criteria:Those who have received thrombolysis or thrombectomy;Patients with transient ischemic attack or Hemorrhagic stroke;Complicated with acute myocardial infarction,Angina pectoris,Heart failure;Severe respiratory tract infections;Severe hepatorenal insufficiency,with malignant tumors;patients with corticosteroid use in the past six months;patients with endocrine diseases such as aldosterone increase and hyperthyroidism?Data collection: All patients were monitored by diastolic blood pressure(SBP)and systolic blood pressure(DBP)after admission?Fasting venous blood was collected,Detection of Blood routine,total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),C-reactive protein(CRP),homocysteine(Hcy),glycosylated hemoglobin(Hb A1c),hemoglobin,fibrinogen(FIB)and D-dimer.Serum NT-pro BNP level was determined by electrochemiluminescence.Grouping method:1)Etiological grouping: According to the etiology/pathogenesis classification criteria of TOAST cerebral infarction,divided into cardiogenic groups(32 cases)and Non-cardiogenic infarction group(include Large-artery atherosclerosis,Small-artery occlusion,Stroke of other determined etiologies,Stroke of undetermined etiology)(60 cases).2)Disease grouping: The patients were divided into groups according to the NIHSS score after admission.NIHSS?4 was divided into mild group(22 cases),4<NIHSS<15 was divided into middle syndrome group(44 cases),NIHSS?15 was divided into severe group(26 cases).3)Prognostic grouping: patients with cerebral infarction received routine treatment after admission.Re-visit of patients at 3 months of treatment.Evaluation of neurological impairment by modified Rankin score: The prognosis of m RS?2 is good(75 cases),MRS >2 score is poor prognosis(17 cases).The differences of indicators in different patients were compared.The linear regression method was used to analyze the influencing factors of serum NT-pro BNP level changes,Subject work(ROC)curvewas drawn to analy predictive value of diagnosis to cardiac cerebral infarction and prognosis.Results: The differences in the levels of hemoglobin,CRP,CRP and NT-pro BNP in different patients had statistical significance(P<0.05).The levels of hemoglobin,serum NT-pro BNP and NIHSS scores in patients with cardiogenic infarction were significantly higher than those in patients with non-cardiac infarction group(P<0.05)single factor analysis showed tha SBP,D-dimer,CRP,FIB,hemoglobin,cause of disease and NIHSS were the influencing factors of serum NT-pro BNP levels in patients with acute cerebral infarction(P<0.05).Multivariate analysis showed that NIHSS,cause of disease and hemoglobin were the influencing factors of serum NT-pro BNP levels(P<0.05);the serum NT-pro BNP level in patients with poor prognosiswas significantly higher than that in patients with good prognosis(P<0.05);The area under the ROC curve for the diagnosis of cardiogenic infarction was 0.745 with serum T-pro BNP levels,the optimal cut-off point was 553.49 pg/m L,and the diagnostic sensitivity and specificity were 75.0% and 70.0%,respectively,the area under the prognosis curve of serum NT-pro BNP was 0.853,the best cut-off value was 673.85 pg/m L.Conclusion: The level of serum NT-pro BNP in patients with acute cerebral infarction is related to the severity of the disease and cause of disease.The main factor of the increase is the degree of infarction,which is also related to the patient's own anemia status,it can be used as an indicator of etiological diagnosis and prognosis prediction. |
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