Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Utility of Measurement of Plasma N-terminal Pro-brain Natriuretic Peptide in Diagnosis of Pulmonary Hypertension

폐동맥고혈압 진단에 있어 N-terminal Pro-brain Natriuretic Peptide 측정의 유용성

  • Hahn, Chang Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kang, Seok Min (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Moon, Jin Wook (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Cho, Jae Hee (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Hwang, Sang Yon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Jung Min (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Moo Suk (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chung, Jae Ho (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young Sam (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Se Kyu (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Shim, Won Heum (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Sung Kyu (Department of Internal Medicine, Yonsei University College of Medicine)
  • 한창훈 (연세대학교 의과대학 내과학교실) ;
  • 강석민 (연세대학교 의과대학 내과학교실) ;
  • 문진욱 (연세대학교 의과대학 내과학교실) ;
  • 조재희 (연세대학교 의과대학 내과학교실) ;
  • 황상연 (연세대학교 의과대학 내과학교실) ;
  • 이중민 (연세대학교 의과대학 내과학교실) ;
  • 박무석 (연세대학교 의과대학 내과학교실) ;
  • 정재호 (연세대학교 의과대학 내과학교실) ;
  • 김영삼 (연세대학교 의과대학 내과학교실) ;
  • 김세규 (연세대학교 의과대학 내과학교실) ;
  • 장준 (연세대학교 의과대학 내과학교실) ;
  • 심원흠 (연세대학교 의과대학 내과학교실) ;
  • 김성규 (연세대학교 의과대학 내과학교실)
  • Published : 2004.01.30
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Abstract

Background : Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. Method : We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. Results : The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. Conclusion : Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.

연구배경 : 만성호흡기질환 환자에서 폐동맥고혈압은 불량한 예후를 나타낸다. 접근성이 용이하고 비침습적인 방법으로서 혈청 NT-proBNP농도 측정이 폐동맥고혈압 진단에 유용성이 있는지 알아보기 위하여 본 연구를 진행하였다. 방 법 : 임상적으로 수축기 폐동맥고혈압이 의심되는 환자 29명을 대상으로 전기화학발광 면역분석법을 이용하여 혈청 NT-proBNP농도를 측정하였고, 동맥혈가스검사, 혈청 생화학검사, 폐기능검사, 그리고 도플러 심초음파검사를 실시하여 우심실 수축기압을 통해 수축기 폐동맥압을 예측하였다. 결 과 : 로그 값으로 치환한 혈청 NT-proBNP농도와 수축기 폐동맥압과는 양성 선형 상관관계를 갖고 있었다(Correlation coefficiency: 0.783, p-value < 0.001). 혈청 NT-proBNP 농도는 우심실 수축기압, 우심실 비대, 심실간 중격의 편평화, 우심실 확장과 유의한 관련이 있었다. 결 론 : 임상적으로 폐동맥고혈압을 의심하는 환자에서 혈청 NT-proBNP 농도 측정은 간단하게 폐동맥고혈압 유무를 알 수 있는 유용한 표지자로서 사용이 가능할 것으로 보이며, 이에 대한 추가 연구가 필요하리라 생각된다.

Keywords

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