血清c-TNT、BNP对脑损伤后脑心综合征的诊断价值

The Predictive Value of Early Serum c-TNT, NT-proBNP Levels in Brain Heart Syndrome Following the Cerebral Vascular Disease

摘要: 目的：探讨早期血清中肌钙蛋白T (c-TNT)、氨基末端B型利钠肽前体(NT-proBNP)水平在预测脑血管疾病患者住院期间脑心综合征发生情况的临床价值。方法：该研究为回顾性研究。选取2020年5月至2020年10月本院神经外科收治的222例脑血管疾病患者，根据住院期间是否发生脑心综合征分为脑心综合征组(BHS, n = 34)和非脑心综合征组(Non-BHS, n = 188)。收集两组患者临床资料：基本信息、入院72 h内的血清c-TNT、NT-proBNP、心肌酶谱水平以及确诊脑心综合征后的心功能指标等。通过比较两组患者间血清c-TNT和NT-proBNP水平的差异，评价早期血清c-TNT、NT-proBNP对脑血管疾病患者发生脑心综合征的情况以及发生脑心综合征后心功能的预测价值。结果：1) 相比较于Non-BHS组，BHS组患者血清c-TNT、NT-proBNP明显升高(P < 0.05)；2) BHS组患者左室射血分数及三尖瓣环位移显著低于Non-BHS组；3) 早期血清c-TNT、NT-proBNP水平预测住院期间脑心综合征受试者工作特征曲线(ROC)下面积分别为0.872和0.824，两者的灵敏度分别为0.675和0.647，特异度分别为0.947和0.899；4) 相比较于Non-BHS组，BHS组患者住院时间明显延长(P < 0.05)。结论：早期c-TNT、NT-proBNP水平对脑心综合征具有较好的预测价值，针对性预防脑心综合征的发生可减轻住院期间心功能损伤，从而缩短患者的住院时间。

Abstract: Objective: To investigate the clinical value of early serum troponin T (c-TNT) and N-terminal B-type natriuretic peptide precursor (NT-proBNP) levels in predicting the occurrence of brain-heart syndrome following cerebral vascular diseases during hospitalization. Methods: This study was a retrospective study. A total of 222 patients with cerebral vascular diseases who were admitted to our hospital from May 2020 to October 2020 were included and divided into BHS group (BHS, n = 34) and non-BHS group (Non-BHS, n = 188). Clinical data of patients in the two groups were collected: basic information, serum c-TNT, NT-proBNP, myocardial enzyme levels within 72 h of admission and cardiac function indicators after the diagnosis of BHS. To compare the differences of serum c-TNT and NT-proBNP levels between the two groups of patients, and evaluate the predictive value of early serum c-TNT and NT-proBNP on the occurrence of BHS in patients with cerebrovascular diseases and the cardiac function after the occurrence of BHS. Results: 1) Compared with the Non-BHS, The levels of c-TNT and NT-proBNP in BHS group were increased significantly (P < 0.05). 2) The left ventricular ejection fraction and tricuspid annulus displacement in the BHS group were significantly lower than those in the Non-BHS group. 3) The early serum c-TNT and NT-proBNP levels predicted the area under the receiver operating characteristic curve curve (ROC) of brain-heart syndrome during hospitalization to be 0.872 and 0.824, respectively. The sensitivity and specificity of the two methods were 0.675 and 0.647, respectively. 4) Compared with the Non-BHS group, the hospital stay of patients in the BHS group was significantly prolonged (P > 0.05). Conclusion: Early levels of c-TNT and NT-proBNP have good predictive value for BHS. Targeted prevention of BHS can reduce cardiac function damage during hospitalization, thus shortening the hospital stay of patients.