中文摘要：

目的探讨血浆氨基末端脑利钠肽前体（NT-pro-BNP）在评估颅脑创伤（TBI）严重程度及颅内压（ICP）增高中的应用价值。方法选择2009年1月到2009年12月收入我院神经外科的63例颅脑创伤患者作为研究对象。收集的资料包括患者的性别、年龄、入院时GCS评分、受伤机制、颅内压数值、总住院天数、重症监护病房（ICU）住院天数。按照患者入院时最初的GCS评分将其分为轻度颅脑创伤组（GCS 13-15,n=14）,中度颅脑创伤组（GCS 9-12,n=24）,重度颅脑创伤组（GCS 3-8,n=25）三组。应用电化学发光免疫分析技术测定血浆NT-pro-BNP浓度。结果重度颅脑创伤组血浆NT-pro-BNP水平显著高于轻度颅脑创伤组及中度颅脑创伤组（F=12.590,P〈0.01）。同ICP控制组（n=15）249.3 pg/ml±103.8 pg/ml及未行ICP监测组（n=40）221.9 pg/ml±142.7 pg/ml相比,ICP增高组（n=5）NT-pro-BNP血浆浓度520.2 pg/ml±153.5 pg/ml可出现显著增高（P〈0.01）。血浆NT-pro-BNP水平与GCS评分及ICU住院天数存在相关性。结论颅脑创伤早期血浆NT-pro-BNP水平越高,其伤后颅内压控制难度越大。血浆NT-pro-BNP水平可作为判断颅脑创伤严重程度及颅内压增高程度的一个潜在评估指标,有助于及早预判颅内压增高并及时地对其进行干预。

英文摘要：

Objective To evaluate the value of plasma N-terminal pro-brain natriuretic peptide（NT-pro-BNP） in the assessment of the severity of traumatic brain injury（TBI） and increased intracranial pressure（ICP）.Methods From January 2009 to December 2009,63 TBI patients admitted to Neurosurgery Departmentof our hospital were studied.Clinical data were collected,including sex,age,Glasgow Coma Scale（GCS） score at admission,mechanism of injury,ICP values,inpatient days and intensive care unit（ICU） days.Patients were subsequently divided into mild TBI group（GCS 13~15,n=14）,moderate TBI group（GCS 9~12,n=24）,severe TBI group（GCS 3~8,n=25） according to the initial GCS score.NT-pro-BNP levels were analyzed using an electrochemiluminescence immunoassay.Results NT-pro-BNP levels were increased significantly in the severe TBI group compared to mild and moderate TBI groups（F=12.590,P0.01）.NT-pro-BNP levels were increased in patients with elevated ICP as compared to patients without elevated ICP or without ICP monitoring（520.2 pg/ml±153.5 pg/ml,n=5 vs.249.3 pg/ml±103.8 pg/ml,n=15 and 221.9 pg/ml±142.7 pg/ml,n=40;P0.01）.NT-pro-BNP levels correlated with GCS and ICU days.Conclusion It is hard to control the ICP in patient with high plasma NT-pro-BNP level in early stage.NT-pro-BNP levels seem to be a potential predictor for the severity of TBI and the degree of ICP,and are helpful in prediction and treatment of increased ICP at early stage.