李运平　余国峰　戴伟民

[摘要] 目的 探讨急性脑出血患者血浆NT-pro BNP、和肽素与病情严重程度及脑出血量的相关性。 方法 选择我院2015年1～12月收治的急性脑出血患者42例作为研究组，选取同期健康体检人员42例作为对照组，对比两组患者血浆NT-pro BNP及和肽素水平，分析其与脑出血量的关系。 结果 研究组血浆NT-pro BNP水平、和肽素水平以及出血量均显著高于对照组（P<0.05）；研究组轻型、中型以及重型患者比较，NT-pro BNP水平及和肽素水平差异均有统计学意义（P<0.05），研究组血浆NT-pro BNP水平、和肽素水平与脑出血量呈正相关，与GCS评分呈负相关，组间对比均有显著差异（P<0.05）；与少量出血患者及中量出血患者相比，大量出血患者的NT-pro BNP浓度指数显著上升（P<0.05），表明NT-pro BNP水平同出血量存在显著相关性。结论 急性脑出血患者血浆NT-pro BNP及和肽素水平显著上升，与患者的病情严重程度及脑出血量存在密切联系。

[关键词] 急性脑出血；血浆NT-pro BNP；和肽素；脑出血量；格拉斯哥评分

[中圖分类号] R743.34 [文献标识码] A [文章编号] 1673-9701（2017）16-0007-03

[Abstract] Objective To investigate the correlation between plasma NT-pro BNP， copeptin and the severity of the disease， the amount of cerebral hemorrhage in patients with acute cerebral hemorrhage. Methods A total of 42 patients with acute cerebral hemorrhage admitted in our hospital from January to December 2015 were selected as the study group. 42 healthy subjects in the same period were selected as the control group. The levels of plasma NT-pro BNP and copeptin between the two groups were compared. And the relationship of NT-pro BNP and copeptin with the amount of cerebral hemorrhage was analyzed. Results The levels of plasma NT-pro BNP， copeptin and the amount of hemorrhage in the study group were significantly higher than those in the control group（P<0.05）. There were significant differences in the levels of NT-pro BNP and copeptin in the mild， moderate and severe patients of the study group（P<0.05）. The plasma NT-pro BNP， copeptin were positively correlated with the amount of cerebral hemorrhage and were negatively correlated with GCS score in the study group， and there was significant difference between groups（P<0.05）. The NT-pro BNP concentration index was significantly higher in patients with heavy bleeding compared with that in patients with mild and moderate bleeding（P<0.05）， indicating that NT-pro BNP level was significantly associated with the amount of hemorrhage. Conclusion The levels of plasma NT-pro BNP and copeptin in patients with acute cerebral hemorrhage increased significantly， which are closely related to the severity of the disease and the amount of cerebral hemorrhage in patients.

[Key words] Acute cerebral hemorrhage； Plasma NT-pro BNP； Copeptin； The amount of cerebral hemorrhage； Glasgow score

临床治疗中，脑出血是一种常见的多发性神经内科疾病[1]。该病致残及死亡人次一直居高不下，目前在人类致死率较高疾病中仅次于恶性肿瘤及心血管疾病位居第三位[2]。因生活水平、生活方式不断改善，人们饮食习惯发生改变，伴随出现血压、血脂异常，最终诱发心脑血管病变，心血管疾病是一种病程长且复发性极高的慢性疾病[3]。国内心血管类病症复发及死亡人数均在冠心病之上，脑出血在脑血管疾病中占28%左右，具备病情发展快速，患者病情严重，可合并各种并发症，预后效果不理想，后遗症严重[4]，对患者身心影响严重。因此对患者病症以及后期评估数据做出有效评估是临床研究重点，目前研究数据显示NT-pro BNP水平在出现脑梗死或者脑出血的患者体内含量明显提升，由此判定NT-pro BNP水平有可能将作为脑出血患者病情发展及预后的重要指标之一。研究为了探讨NT-pro BNP水平、和肽素水平以及脑出血量与畸形脑出血患者病情严重关系，对我院2015年1～12月收治的42例急性脑出血患者与正常人群进行对比分析，效果理想，现报道如下。……