N-terminal pro-B-type natriuretic peptide in patients with isolated traumatic brain injury: a prospective cohort study.
N-terminal pro-B-type natriuretic peptide in patients with isolated traumatic brain injury: a prospective cohort study.
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孤立性创伤性脑损伤患者的 N 末端 B 型利钠肽前体：一项前瞻性队列研究。
DOI：
10.1097/ta.0b013e3182277b69
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Jin Hu
中科院分区：
文献类型：
--
作者：
Xing Wu;H. Sha;Yirui Sun;Liang Gao;Hua Liu;Q. Yuan;Tao Zhang;J. Zhu;Liangfu Zhou;Jin Hu
背景
脑钠肽（BNP）在脑外伤（TBI）后的作用尚不清楚，其与低钠血症的关系仍存在争议。本研究的目的是调查 TBI 患者 N 末端 (NT)-proBNP 的分泌模式，并评估 NT-proBNP、钠平衡和颅内压 (ICP) 之间的关系。
方法
我们从受伤后第 1 天到第 14 天每天测量 84 名孤立性 TBI 患者的血清 NT-proBNP 水平。
结果
平均而言，受伤后第 3 天测得的 BNP 水平峰值为 703.9 pg/mL±179.1 pg/mL，这与 TBI 的严重程度相关。在严重TBI患者中，低钠血症患者血浆NT-proBNP浓度显着高于无低钠血症患者（p<0.05）。低钠组血浆NT-proBNP在伤后48小时内增至峰值1001.16 pg/mL±131.52 pg/mL，并维持高水平3 d。在正常血压组中，血浆NT-proBNP在第5天达到峰值826.43 pg/mL±337.43 pg/mL，此后迅速下降。此外，我们发现ICP>15 mm Hg的患者血浆NT-proBNP浓度显着高于ICP≤15 mm Hg的患者（p<0.01）。
结论
这项研究提供了 TBI 后 BNP 血浆浓度迅速增加的证据。严重 TBI 患者的血浆 BNP 浓度与低钠血症相关，但轻度和中度 TBI 患者则不然。此外，ICP升高的患者在受伤后的前4天内血清BNP水平较高。
BACKGROUND
The role of brain natriuretic peptide (BNP) after traumatic brain injury (TBI) remains unclear, and its relationship with hyponatremia is still controversial. The aim of this study is to investigate the secretion pattern of N-terminal (NT)-proBNP in patients with TBI and to assess the relationship between NT-proBNP, sodium balance, and intracranial pressure (ICP).
METHODS
We measured serum NT-proBNP levels of 84 patients with isolated TBI on a daily basis from day 1 to day 14 after injury.
RESULTS
In average, the peak of BNP level was measured at 703.9 pg/mL±179.1 pg/mL on day 3 after injury, which was correlated to the severity of TBI. Among patients with severe TBI, plasma NT-proBNP concentrations in patients with hyponatremia were statistically higher than those without hyponatremia (p<0.05). In the hyponatremic group, the plasma NT-proBNP increased to a peak of 1001.16 pg/mL±131.52 pg/mL within 48 hours after injury and maintained at a high level for 3 days. In the normonatremic group, the plasma NT-proBNP reached a peak of 826.43 pg/mL±337.43 pg/mL on day 5 and quickly decreased thereafter. In addition, we found plasma NT-proBNP concentrations in patients with ICP>15 mm Hg were significantly higher than those in patients with ICP≤15 mm Hg (p<0.01).
CONCLUSIONS
This study provides evidence that BNP plasma concentrations increase rapidly after TBI. Plasma BNP concentrations are correlated with hyponatremia in severe TBI patients but not in mild and moderate TBI patients. Furthermore, patients with elevated ICP have a higher serum BNP level in first 4 days after injury.
影响因子：
15.9
作者：
MUKOYAMA, M;NAKAO, K;IMURA, H
通讯作者：
IMURA, H
影响因子：
--
作者：
Moro, Nobuhiro;Katayama, Yoichi;Kojima, Jun
通讯作者：
Kojima, Jun
影响因子：
2.9
作者：
Nakagawa, K;Yamaguchi, T;Ohno, K
通讯作者：
Ohno, K