| Objective:Combining clinical medicine with laboratory medicine,the changes of blood levels of N-terminal Pro-brain Natriuretic Peptide(NT-proBNP),Hom-ocysteine(Hcy),D-dimer(D-D)in the early stage of acute cerebral infarction were analyzed to explore the diagnostic value of NT-proBNP,Hcy and D-D in the early stage of acute cerebral infarction.It will provides a new method for clinical intervention in early stage of acute cerebral infarction,and improve the prognosis of patients.Methods:Patients with acute cerebral infarction within 48 hours after admission were selected as the study subjects(case group)and healthy persons who were examined at the same time were used as the control group.The blood levels of NT-proBNP,Hcy and D-D were measured by fluorescence immunochromato-graphy,enzyme circulation assay and glue milk enhancement immune transmission ratio turbidimetric method respectively.Adama typing method was used to classify the cases group,that is,large infarction(>3 cm,involving more than two anatomical parts of the brain),small infarction(1.5～ 3cm)and lacunar infarction(≤ 1.5cm).The clinical data of patients in case group were collected and divided into hypertension group,coronary heart disease group,hypertensive coronary heart disease group and non-hypertensive coronary heart disease group according to their history.All patients in the case group were given NT-proBNP,Hcy,D-D determination within 48 hours of admission,and CT and/or MRI examination during the hospitalization.In control group,NT-proBNP,Hcy,D-D and brain CT examination were performed during physical examination.Results:A total of 80 patients with acute cerebral infarction were enrolled.The average age of the patients was 67.75±11.69 years old,39 males(48.75%)and 41 females(51.25%).A total of 50 health examiners were included.The average age was 64.24±14.01 years old.There were 30 males(60%)and 20 females(40%).1.The blood levels of NT-proBNP,Hcy and D-D in the early stage of acute cerebral infarction were significantly higher in the case group[(721.67±281.62)pg/ml,(17.29±4.06)μmol/L,(1.79±0.62)mg/L] than in the control group[(89.54±65.67)pg/ml,(8.14±3.20)μmol/L,(0.25±0.18)mg/L].The difference was statistically significant(P<0.05).2.According to Adama classification,18 cases were in large infarction group(18/80),38 cases were in small infarction group(38/80),and 24 cases were in lacunar infarction group(24/80).The blood levels of NT-proBNP,Hcy and D-D in large infarction group[(1057.68±359.93)pg/ml,(20.83±3.93)μmol/L,(2.86±1.06)mg/L] were higher than those in small infarction group [(689.36±239.5)1pg/ml,(17.12±4.36)μmol/L,(1.75 ±0.61)mg/L].The difference was statistically significant(P<0.05).The blood NT-proBNP,Hcy and D-D levels in large infarction group were higher than those in lacunar infarction group [(520.82±159.68)pg/ml,(14.95±3.73)μmol/L,(1.06±0.35)mg/L].The differ-ence was statistically significant(P<0.05).The blood NT-proBNP,Hcy and D-D levels in small infarction group were also higher than those in lacunar infarction group.The difference was statistically significant(P<0.05).3.The acute cerebral infarction group was divided into four groups according to the medical history.29 cases(29/80)had history of hypertension,10 cases(10/80)had history of coronary heart disease,21 cases(21/80)had history of coronary heart disease and hypertension,and 20 cases(20/80)had no history of coronary heart disease and hypertension.The blood NT-proBNP,Hcy and D-D levels in hypertension and coronary heart disease[(1045.80±432.29)g/ml,(24.61±4.89)μmol/L,(2.89±0.56)mg/L]were higher than those in hypertension group[(710.23±232.83)pg/ml,(16.26±4.30)μmol/L,(1.67±0.51)mg/L].The difference was statistically significant(P<0.05).The blood NT-proBNP,Hcy and D-D levels in hypertension and coronary heart disease group were also higher than those in coronary heart disease group[(739.36± 237.87)pg/ml,(18.83±3.36)μmol/L,(1.76±1.06)mg/L].The difference was statistical significant(P<0.05).The blood NTproBNP,Hcy and D-D levels in hypertension and coronary heart disease group were significantly higher than those in no hypertension or coronary heart disease group[(389.08±110.16)pg/ml,(10.33±3.44)μmol/L,(0.82±0.45)mg/L].The difference was statistically significant(P<0.05).There was no difference in blood NT-proBNP,Hcy and D-D levels between hypertension group and coronary heart disease group(P>0.05).The blood NT-proBNP,Hcy and D-D levels in hypertension group were higher than those in no hypertension or coronary heart disease group.The difference was statistically significant(P<0.05).The blood NT-proBNP,Hcy and D-D levels in the coronary heart disease group were also higher than those in no hypertension or coronary heart disease group.The difference was statistically significant(P<0.05).Conclusion:1.In the early stage of acute cerebral infarction,the levels of NT-proBNP,Hcy and D-D in blood were significantly higher than those in normal subjects.Therefore,for patients suspected of acute cerebral infarction,NT-proBNP,Hcy and D-D should be detected in time.2.The levels of NT-proBNP,Hcy and D-D in blood were correlated with infarct size.Moreover,with the increase of infarct size,the levels of NT-proBNP,Hcy and D-D gradually increased.3.The levels of NT-proBNP,Hcy and D-D in blood of patients with acute cerebral infarction are affected by coronary heart disease or hypertension.The blood NT-proBNP,Hcy and D-D levels were higher in patients with coronary heart disease and hypertension.Therefore,coronary heart disease and/or hypertension are risk factors for the elevation of blood NT-proBNP,Hcy and D-D levels in patients with acute cerebral infarction. |
PDF Full Text Request