实用医学杂志2018，Vol.34Issue(1)：44-48,5.DOI:10.3969/j.issn.1006-5725.2018.01.011
B型脑钠肽联合D-二聚体对心源性栓塞型脑卒中患者的快速筛选价值
The value of using B-type natriuretic peptide and D-dimer in preliminary recognition of cardioembolic stroke patients
摘要
Abstract
Objective To determine the value of using B-type natriuretic peptide (BNP) and D-dimer in preliminary recognition of cardioembolic stroke patients.Methods A mutilple-center study was conducted in Foshan Hospital of traditional Chinese Medicine (TCM) and its affiliated hospitals from July 2015 to July 2016.In the emergency departments (EDs),emergency physicians prospectively assessed consecutive adult patients with acute cardioembolic stroke and measured plasma BNP by POCT platform on admission,then followed up.Stroke neurologists evaluated patients' functional outcome at hospital discharge and also made discharge diagnosis and stroke etiologic subtypes according to the TOAST criteria.Results In this study,290 acute ischemic stroke patients met the study criteria [mean age (68.41 ± 12.06) years;53.8％ female].Of the enrolled patients,28.3％ were diagnosed with LAA at discharge,17.9％ with CE,42.8％ with SAO,11.0％ with SOE or SUE.And the mean BNP concentration was significantly higher in the CE group than that in other three subtypes (P ＜ 0.001).After adjustment for multiple clinical predictors like gender,age,coronary artery disease,atrial fibrillation and renal function,BNP and D-dimer were associated with CE [BNP OR:1.044 (95％ CI 1.025,1.064),P ＜ 0.001;D-dimer OR:1.511(95％ CI 1.020,2.238),P =0.039,respectively].Conclusion Through POCT technique in the EDs,cardioembolic stroke patients can be differentiated from other TOAST subtypes.BNP with/without D-dimer has good but different corresponding diagnostic performance in preliminary recognition of cardioembolic stroke patients.关键词
急性缺血性脑卒中/心源性脑卒中/床边及时检测/TOAST分型Key words
acute ischemic stroke/cardioembolic stroke/point-of-care test/TOAST criteria引用本文复制引用
吴智鑫,李莹莹,梁斯娜,秦锋周,雷俊娜,陈景利,何明丰,李旷怡..B型脑钠肽联合D-二聚体对心源性栓塞型脑卒中患者的快速筛选价值[J].实用医学杂志,2018,34(1):44-48,5.基金项目
广东省科技厅社会发展项目(编号:2014A020212002) （编号:2014A020212002）
广东省佛山市科技局医学类科技攻关项目(编号:2014AB00328、2015AB00354、2015AB00355) （编号:2014AB00328、2015AB00354、2015AB00355）
广东省佛山市科技创新平台项目(编号:2014AG10002),佛山市重点专科培育项目(编号:Fspy2-2015004) （编号:2014AG10002）
佛山市十三五高水平重点专科建设项目(编号:FSGSSPZD135025) （编号:FSGSSPZD135025）
