응급실에 내원한 간경화 환자의 pro-BNP 상승에 대한 임상적 고찰 (Clinical Investigation of pro-BNP in Hepatic Cirrhosis Patients in an Emergency Department)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 20권 / 3호 / 310 ~ 315페이지
· 저자명 : 이석우, 김훈, 박정수

초록

Purpose: Cardiac dysfunction may be present in patients
with hepatic cirrhosis. This study was performed to evaluate
the plasma concentration of pro Brain Natriuretic Peptide
(pro-BNP), a marker of severity of hepatic cirrhosis and cardiac
dysfunction.
Methods: We retrospectively analyzed the medical records
of 85 patients who had been diagnosed with hepatic cirrhosis
and admitted through the emergency department.
Circulating levels of pro-BNP, Child-Pugh class and
Sequential Organ Failure Assessment (SOFA) score were
determined.
Results: Plasma pro-BNP levels were significantly
increased in cirrhotic patients with ascites or heart failure
(p=0.000, p=0.000, respectively) but not in patients with
encephalopathy or gastrointestinal bleeding (p=0.396,
p=0.059, respectively). Circulating pro-BNP levels were
closely correlated with SOFA scores (r=0.331, p=0.002)
and correlated with Modified Child-Pugh classification
scores (r=0.273, p=0.033). The SOFA score is an easily
applied tool with good prognostic abilities, but pro-BNP and
Child-Pugh class can also be used to enhance clinical judgment
of prognosis.
Conclusion: Increased pro-BNP levels are likely related to
the severity of disease in hepatic cirrhosis. Advanced cirrhosis
is associated with advanced cardiac dysfunction and
pro-BNP has prognostic value for cirrhosis.

영어초록

Purpose: Cardiac dysfunction may be present in patients
with hepatic cirrhosis. This study was performed to evaluate
the plasma concentration of pro Brain Natriuretic Peptide
(pro-BNP), a marker of severity of hepatic cirrhosis and cardiac
dysfunction.
Methods: We retrospectively analyzed the medical records
of 85 patients who had been diagnosed with hepatic cirrhosis
and admitted through the emergency department.
Circulating levels of pro-BNP, Child-Pugh class and
Sequential Organ Failure Assessment (SOFA) score were
determined.
Results: Plasma pro-BNP levels were significantly
increased in cirrhotic patients with ascites or heart failure
(p=0.000, p=0.000, respectively) but not in patients with
encephalopathy or gastrointestinal bleeding (p=0.396,
p=0.059, respectively). Circulating pro-BNP levels were
closely correlated with SOFA scores (r=0.331, p=0.002)
and correlated with Modified Child-Pugh classification
scores (r=0.273, p=0.033). The SOFA score is an easily
applied tool with good prognostic abilities, but pro-BNP and
Child-Pugh class can also be used to enhance clinical judgment
of prognosis.
Conclusion: Increased pro-BNP levels are likely related to
the severity of disease in hepatic cirrhosis. Advanced cirrhosis
is associated with advanced cardiac dysfunction and
pro-BNP has prognostic value for cirrhosis.

참고자료

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