目的探讨急性中重度颅脑损伤患者血浆B型脑钠肽前体水平(BNP)对患者CT临床特征的影响,为临床辅助评估颅脑损伤病情提供参考。方法选取2013年1月—2014年8月该院收治的发病24h以内的69例急性中重度颅脑损伤患者为研究对象,所有患者入院后立即行头颅CT扫描,记录所有患者的CT临床特征表现,并行Rotterdam CT评分,同时检测患者血浆BNP水平,另外同期选取70例健康体检者为对照组做对照,分析血浆BNP水平对患者CT临床特征表现的影响。结果颅脑损伤患者血浆BNP水平明显高于对照组(P<0.05);CT检查临床特征表现中具有基底池完全闭塞、中线移位>5mm、脑室受压比值≤0.2、伴有蛛网膜下腔出血、Rotterdam CT评分>3分与血浆高水平BNP密切相关(P<0.05);在血浆BNP高分组(BNP≥179.48pg/ml)组患者CT检查临床特征表现中,基底池情况及中线移位评分、Rotterdam CT评分、蛛网膜下腔出血的发生率高于低水平组(P<0.05),而脑室受压比值及GSC评分小于低水平组(P<0.05);相关分析提示血浆BNP水平与RotterdamCT评分、中线移位、基底池情况分级呈正相关(P<0.05),而与脑室受压比值GSC评分呈负相关(P<0.05);多因素Logistic回归分析显示:血浆BNP水平(OR=2.421,P<0.05)是Rotterdam CT评分>3分的独立预测因素。结论血浆BNP水平对急性中重度颅脑损伤患者CT检查中不同临床特征表现有一定影响,并且与Rotterdam CT评分密切相关,有利于辅诊科室评估中重度颅脑损伤患者的病情严重程度并作出相应的影像学诊断。 Objective To investigate the effect of plasma BNP level on the clinical features of patients with CT in acute moderate-severe traumatic brain injury and to provide a reference for the clinical evaluation of the brain injury. Methods A total of 69 patients with acute moderate-severe traumatic brain injury admitted to our hospital from January 2013 to August 2014 were enrolled in this study. All patients underwent CT scans immediately after admission, and the clinical features of all patients were recorded , Rotterdam CT scoring was performed in parallel. Plasma BNP level was also measured. In addition, 70 healthy people were selected as the control group in the same period, and the effect of plasma BNP levels on the clinical features of the patients was analyzed. Results Plasma BNP levels in patients with craniocerebral injury were significantly higher than those in the control group (P <0.05). The clinical manifestations of CT were complete occlusion of basilar pool, central line shift> 5mm, ventricular compression ratio ≤0.2, and subarachnoid space Hemorrhage, Rotterdam CT score> 3 points was closely related to plasma BNP level (P <0.05). In the clinical manifestations of CT examination in patients with plasma BNP level (BNP≥179.48pg / ml), the basal cell pool and midline shift The Rotterdam CT score and subarachnoid hemorrhage were higher than those in the low group (P <0.05), while the ventricular compression ratio and GSC score were lower than those in the low group (P <0.05). Correlation analysis showed that plasma BNP levels were significantly correlated with RotterdamCT score, midline shift and basement pool status were positively correlated (P <0.05), but negatively correlated with GSC score (P <0.05). Multivariate Logistic regression analysis showed that plasma BNP level was significantly higher , P <0.05) were independent predictors of Rotterdam CT score> 3. Conclusions Plasma BNP levels have some influence on the clinical features of CT examination in acute moderate-severe traumatic brain injury and are closely related to the Rotterdam CT score, which is helpful to evaluate the severity of patients with severe traumatic brain injury Imaging diagnosis.