ÖZET

Giriş:

Bronşiyolitli hastalarda plazma B tipi natriüretik peptid (BNP) düzeyinin klinik önemi ve hastalık seyri ile ilişkisi konusunda bilgimiz sınırlıdır. Bu çalışmanın amacı orta-ağır bronşiyolit tanısı ile hastaneye yatırılan ve eşlik eden başka hastalığı olmayan hastaların bazal plazma BNP değerleri ile sol ventrikül sistolik fonksiyonları ve hastalık prognozu arasındaki ilişkiyi araştırmaktır.

Yöntemler:

Çalışmada bronşiyolit tanısı alan, modifiye Wang solunum skoru ≥6 olan, 1-24 ay arasındaki 37 hasta ileriye dönük olarak incelendi. Plazma BNP düzeyi yüksek (>100 pg/mL, n=6) ve normal (≤100 pg/mL, n=31) olan hastalar sol ventrikül sistolik işlevleri, yaşamsal bulgular, laboratuvar sonuçları ve radyolojik bulgular açısından karşılaştırıldı. Plazma BNP düzeyi ile prognoz arasındaki ilişki değerlendirildi.

Bulgular:

Hastaların ortalama plazma BNP düzeyi, sağlıklı kontrol grubundan yüksek saptandı (61,75±65 pg/mL’ye karşılık 13,99±8,79 pg/mL, p=0,001). Plazma BNP düzeyi normal ve yüksek olan hastalar ile sağlıklı kontrol grubunun ejeksiyon fraksiyonu ve fraksiyonel kısalma değerleri arasında fark saptanmadı (p>0,05). Plazma BNP düzeyi yüksek olan hastaların ortalama kısmi karbondioksit basıncı değeri, BNP düzeyi normal olan hastalardan yüksek bulundu (p=0,037). Plazma BNP düzeyi ile hastanede yatış süresi (r=0,286; p=0,007) ve yoğun bakımda yatış süresi (r=0,645; p=0,000) arasında pozitif bir korelasyon saptandı.

Sonuç:

Orta-ağır bronşiyolitli hastalarda miyokard işlev bozukluğu olmaksızın plazma BNP artışı görülebilir. Bu artış, hastalığa bağlı pulmoner gaz değişimindeki bozulmanın derecesi ile ilişkili olabilir. Plazma BNP düzeyi, orta-ağır bronşiyolitli hastalarda hastalık seyrini öngörmede potansiyel bir biyobelirteçtir.

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Orta-Ağır Bronşiyolitli Hastalarda Plazma B-Tipi Natriüretik Peptid Düzeyleri ile Sol Ventrikül Sistolik Fonksiyonları ve Hastalık Seyri Arasındaki İlişki

ÖZET

References