Relationship between plasma level of N-terminal pro-brain natriuretic peptide and the prognosis in patients with traumatic brain injury

QIAN Chun-sheng; ZHANG Bin; QIAN Teng-da; HE Yun-wen; LI Yi-huan; DONG Ji-rong

doi:10.13798/j.issn.1009-153X.2017.04.009

Abstract：Objective To investigate the relationship of the plasma level of N-terminal pro-brain natriuretic peptide (NT-proBNP) with the severity and prognosis in the patients with traumatic brain injury (TBI).Methods The fasting venous blood plasma levels of the NT-proBNP were detected by electrochemiluminescence method in 100 patients with TBI,of whom,42 suffered from mild TBI,37 moderate TBI and 21 severe TBI,and 100 healthy subjects from Febrmry,2013 to December,2015.The relationship of the plasma levels of NT-proBNP with injury severity degree and prognosis were analyzed.Results The plasma level of NT-proBNP [(140.9±53.8) pg/ml] was significantly higher in the patients with TBI than that [(32.5±19.3) pg/ml] in the healthy subjects (P＜0.05).The plasma level of NT-proBNP [(245.9±61.3) pg/ml] in patients with severe TBI was significantly higher than that [(145.9±47.2) pg/ml] in the patients with moderate TBI (P＜0.05),which was significantly higher than that [(86.2±31.5) pg/ml] in the patients with mild TBI (P＜ 0.05).The plasma level of NT-proBNP [(259.3±67.3) pg/ml] was significantly higher in the dead patients (n=24) than that [(100.4±59.7)pg/ml] in the survival patients (P＜0.05).The area under receiver operating characteristic curve of NT-proBNP levels predicting death of patients with TBI was AUC=0.932,95％CI (0.814 ～ 0.971).The best critical value of NT-proBNP determining death of patients with TBI was 144.8 pg/ml,and the corresponding sensitivity and specificity were 81.53％ and 91.47％ respectively.Conclusions The determination of the plasma NT-proBNP levels is very helpful to assessment of injury severity in the patients with TBI.It is suggested that the plasma level of NT-proBNP is of the important value to predicting the clinical treatment outcomes in the patients with TBI.