Karaciğer sirozu olan hastalarda kardiyak disfonksiyonu gösteren bir serum markeri olan pro-BNP seviyeleri ile hastalık göstergeleri arasındaki ilişki
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Date
2010
Authors
Veyseloğlu, Latif
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Beyin Natriüretik Peptidi (BNP) ve pro-Beyin Natriüretik Peptidi (pro-BNP) değerlerinin ölçümü konjestif kalp yetersizliğinde tanısal değere sahiptir. Bu çalışmada, karaciğer hastalıklarının şiddeti ile N terminal Beyin Natriüretik Peptidi (NT pro-BNP) seviyeleri arasındaki ilişkinin ortaya konması için karaciğer sirozu tanılı hastalarda altta yatan karaciğer hastalığının ciddiyeti, Child-Pugh ve Model for end-stage liver disease (MELD) skorunda artış olmasıyla birlikte NT pro-BNP düzeyinde yükselme olup olmadığının değerlendirilmesi amaçlanmıştır. Çalışmamız Uludağ Üniversitesi Tıp Fakültesi Gastroenteroloji polikliniği ve kliniğine başvuran hastalar arasından seçilen 120 kişi ile (60 hasta ve 60 kontrol) yapıldı. Hasta ve kontrol grubundan alınan kanlardan pro-BNP düzeyleri ölçüldü. Hasta grubuna ayrıca Ekokardiyografi (EKO) yapılarak Ejeksiyon fraksiyon (EF) seviyeleri ölçüldü. Böylece kalp yetersizliği olan hastalar dışlandı. Olguların yaş ortalaması 47,5 ± 12,8 yıl (18-75) idi. Hasta grubunda erkek/kadın oranı 36/24 idi. Kontrol grubunda erkek/kadın oranı 19/41 idi. Hasta grubunda ortalama pro-BNP düzeyleri 234,5 idi. Hasta grubunda Child-Pugh ve MELD skoruna göre NT pro-BNP düzeyleri değerlendirildiğinde anlamlı fark vardı (p<0,05). Kontrol grubunda ortalama pro-BNP düzeyleri 43,5 idi, pro-BNP seviyeleri açısından hasta ile kontrol grubu karşılaştırıldığında arada anlamlı farklılık saptandı (p<0,05). NT pro?BNP kalp yetmezliği olmayan kronik karaciğer hastalığı olan kişilerde karaciğer hastalığının şiddeti ile artmaktadır ve mortalitenin ön belirleyicisi olarak kullanılabilecek ucuz, noninvaziv ve çabuk sonuç alınabilecek serolojik bir belirteç olarak değerlendirilebilir. Sonuç olarak çalışmamızda, karaciğer sirozlu hastalarda pro-BNP yüksekliği ile karaciğer hastalığının şiddeti arasında (Child, MELD) anlamlı bir korelasyon gösterildi.
The measurement of Brain Natriuretic Peptide (BNP) and pro-Brain Natriuretic Peptide (pro-BNP) levels has diagnostic value for congestive cardiac failure. In this study, it was aimed to assess whether N terminal Brain Natriuretic Peptide (NT pro-BNP) level increases as severity of underlying liver disease, Child-Pugh and model for end-stage liver disease (MELD) scores worsen, to disclose the association between the severity of liver disease and the levels of NT pro-BNP. Our study was conducted with 120 persons (60 patients and 60 controls) selected from the patients admitted to outpatients clinic and clinic of Department of Gastroenterology of Uludag University Medical School. From blood samples collected from patients and controls, pro-BNP levels were analyzed. In the patients group, Ejection fraction (EF) levels were also evaluated by Echocardiography (ECHO). Thus the patients having cardiac failure were excluded. The mean age of the patients was 47,5 ± 12,8 years (range, 18-75 years). In the patients group, men/women ratio was 36/24. In the group of controls, men/women ratio was 19/41. Average pro-BNP level was 234,5 in the patients group. There was a significant difference when NT pro-BNP levels were evaluated by Child-Pugh and MELD score (p<0,05). In controls group, average pro-BNP level was 43.5 and a significant difference was found when controls and group of the patients were compared with regard to pro-BNP levels (p<0.05). NT pro-BNP increases with the severity of liver disorder in the patients with chronic liver disease who do not have cardiac failure and it can be accepted as an inexpensive, non-invasive serological marker providing rapid results which can be used as a predictor for mortality. In conclusion, in our study, it was demonstrated a significant correlation between elevated pro-BNP levels and the severity of liver disease (Child, MELD) in the patients with liver cirrhosis.
The measurement of Brain Natriuretic Peptide (BNP) and pro-Brain Natriuretic Peptide (pro-BNP) levels has diagnostic value for congestive cardiac failure. In this study, it was aimed to assess whether N terminal Brain Natriuretic Peptide (NT pro-BNP) level increases as severity of underlying liver disease, Child-Pugh and model for end-stage liver disease (MELD) scores worsen, to disclose the association between the severity of liver disease and the levels of NT pro-BNP. Our study was conducted with 120 persons (60 patients and 60 controls) selected from the patients admitted to outpatients clinic and clinic of Department of Gastroenterology of Uludag University Medical School. From blood samples collected from patients and controls, pro-BNP levels were analyzed. In the patients group, Ejection fraction (EF) levels were also evaluated by Echocardiography (ECHO). Thus the patients having cardiac failure were excluded. The mean age of the patients was 47,5 ± 12,8 years (range, 18-75 years). In the patients group, men/women ratio was 36/24. In the group of controls, men/women ratio was 19/41. Average pro-BNP level was 234,5 in the patients group. There was a significant difference when NT pro-BNP levels were evaluated by Child-Pugh and MELD score (p<0,05). In controls group, average pro-BNP level was 43.5 and a significant difference was found when controls and group of the patients were compared with regard to pro-BNP levels (p<0.05). NT pro-BNP increases with the severity of liver disorder in the patients with chronic liver disease who do not have cardiac failure and it can be accepted as an inexpensive, non-invasive serological marker providing rapid results which can be used as a predictor for mortality. In conclusion, in our study, it was demonstrated a significant correlation between elevated pro-BNP levels and the severity of liver disease (Child, MELD) in the patients with liver cirrhosis.
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Keywords
Beyin natriüretik peptidi, Karaciğer sirozu, Brain natriuretic peptide, Liver cirrhosis
Citation
Veyseloğlu, L. (2010). Karaciğer sirozu olan hastalarda kardiyak disfonksiyonu gösteren bir serum markeri olan pro-BNP seviyeleri ile hastalık göstergeleri arasındaki ilişki. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.