内科

目的探讨老年急性缺血性脑梗死患者的血清N端脑钠肽前体（NT-pro-BNP）、同型半胱氨酸（Hcy）水平及其临床意义。方法选取2016年2月至2017年3月在我院住院治疗的老年急性脑梗死患者56例作为观察组，根据发生脑梗死供血区域不同，将其分为前循环组（34例）与后循环组（22例）；根据梗死灶直径大小，将其分为非大面积脑梗死组（33例）与大面积脑梗死组（23例）；根据NIHSS评分不同，将其分为病情轻度组（50例）与病情中重度组（6例）；根据出院后90 d内存活情况，将其分为死亡组（4例）与存活组（52例）。另选取同期住院治疗的非脑血管疾病患者43例作为对照组。比较观察组与对照组、前循环组与后循环组、大面积脑梗死组与非大面积脑梗死组、病情轻度组与病情中重度组、死亡组与存活组患者的血清NT-pro-BNP、Hcy水平。结果观察组患者的血清NT-pro-BNP和Hcy水平均显著高于对照组；大面积脑梗死组、病情中重度组梗死组、死亡脑梗死组患者血清NT-pro-BNP和Hcy水平均显著高于非大面积脑梗死组、病情轻度组与存活组，差异有统计学意义（P＜0.05）。前循环脑梗死组患者血清NT-pro-BNP、Hcy水平与后循环组比较差异无统计学意义（P＞0.05）。结论急性缺血性脑梗死患者的血清NT-pro-BNP、Hcy水平越高，其脑损害面积越大、病情越严重，短期预后越不理想。检测急性缺血性脑梗死患者血清NT-pro-BNP和Hcy水平对判断其病情的严重程度和预测其预后有重要的参考价值。

ObjectiveTo investigate the serum levels of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and homocysteine (Hcy) in elderly patients with acute ischemic cerebral infarction and their clinical significance. Methods56 patients with acute cerebral infarction who were admitted to our hospital from February 2016 to March 2017 were selected as the observation group. They were divided into the anterior circulation group (34 cases) and the posterior circulation group (22 cases) according to the different blood supply areas of cerebral infarction, the non-large area cerebral infarction group (33 cases) and the large area cerebral infarction group (23 cases) according to the size of the infarct size, the mild disease group (50 cases) and the moderate to severe disease group (6 cases) according to the different NIHSS scores, the death group (4 cases) and the survival group (52 cases) according to the survival within 90 days after discharge. Another 43 patients with non-cerebral vascular disease hospitalized during the same period were selected as the control group. The serum levels of NT-pro-BNP and Hcy were compared between the observation group and the control group, the anterior circulation group and the posterior circulation group, the large area cerebral infarction group and the non-large area cerebral infarction group, the mild disease group and the moderate to severe disease group, the death group and the survival group. ResultsThe serum levels of NT-pro-BNP and Hcy in the observation group were significantly higher than those in the control group. The serum levels of NT-pro-BNP and Hcy in the large-area cerebral infarction group, moderate to severe disease group and the death group were significantly higher than those in the non-large area cerebral infarction group, the mild disease group and the survival group. The difference was statistically significant (P＜0.05). There were no significant differences in serum NT-pro-BNP and Hcy levels between the anterior circulation group and the posterior circulation group (P＞0.05). ConclusionThe higher the serum levels of NT-pro-BNP and Hcy, the larger area of brain damage, the more serious disease, the shorter in short-term prognosis in patients with acute ischemic cerebral infarction. The detection of serum NT-pro-BNP and Hcy levels in patients with acute ischemic cerebral infarction has important reference value for judging the severity of the disease and predicting its prognosis.