NT-PRO BNP NATRİÜRETİK PEPTİT:KALP YETMEZLİĞİNE BAĞLI PLEVRAL EFFÜZYONDA YENİ TANI ARACI

Yıl 2015, Cilt: 29 Sayı: 1, 21 - 27, 01.05.2015

Ceyda Anar Fatmanur Çelik Tuba İnal Gülru Polat Serhat Erol Yelda Vatansever Mine Gayaf Nimet Aksel Filiz Güldaval İpek Ünsal Dursun Tatar Ayşe Özsöz Hüseyin Halilçolar Dilek Kalenci

Öz

Amaç: Transüdatif ve eksüdatif sıvıları özellikle diüretik kullanan kalp yetmezliği olan hastalarda birbirinden ayırt etmek bazen zor olmaktadır. Bu çalışmanın amacı kalp yetmezliğine bağlı plevral effüzyonları kalp yetmezliği olmayan plevral effüzyonlardan ayırmada plevral sıvı NT-pro BNP'nin tanısal değerini araştırmaktır. Materyal ve method: Plevral effüzyonu olan 126 hasta çalışmaya alındı. Plevral sıvı ve serum örnekleri eş zamanlı laboratuvara gönderildi. Biyokimyasal analiz, bakteriyel ve mantar kültürü, mycobacterium tuberculosis için yayma ve kültür ve sitolojik inceleme yapıldı. Bulgular: Kalp yetmezliğine bağlı plevral effüzyonlarda NT-proBNP değeri diğer plevral effüzyon nedenlerine göre istatistiksel olarak yüksek saptandı (p (r: 0.91, p <0.001). Kalp yetmezliğine bağlı plevral effüzyonları kalp yetmezliğine bağlı olmayan
plevral effüzyonlardan ayırmada plevral sıvı NTproBNP cut off değeri 5133 pg/ml’de duyarlık
%51,8, özgüllük %98,9 (p:0,000), tanı doğruluğu da %84,1 idi. (r: 0.91, p <0.001). Kalp yetmezliğine bağlı plevral effüzyonları kalp yetmezliğine bağlı olmayan plevral effüzyonlardan ayırmada plevral sıvı NTproBNP cut off değeri 5133 pg/ml’de duyarlık
%51,8, özgüllük %98,9 (p:0,000), tanı doğruluğu da %84,1 idi.

Anahtar Kelimeler

NT-pro BNP, plevral sıvı, kalp yetmezliği

NT-PRO BRAIN NATRIURETIC PEPTIDE:NEW DIAGNOSTIC TOOL FOR HEART FAILURE RELATED PLEURAL EFFUSION

Öz

Aim: Definite diagnosis of transudative or exudative pleural fluids often presents a diagnostic dilemma. The aim of this study was to evaluate whether amino-terminal pro-brain natriuretic peptide (NT-proBNP) levels in pleural fluid has a diagnostic value for discriminating heart-failure related pleural effusions from non-heart-failure effusions. Methods: One hundred twenty six subjects with pleural effusions were included. Samples of pleural fluid and serum were obtained simultaneously from each subject. Biochemical analysis, bacterial and fungal culture, acid-fast bacilli smear, culture and cytology were performed on the pleural fluid. Results: Subjects with heart-failure-related pleural effusion had significantly higher pleural NT-proBNP levels than other subjects (P < 0.000). Pleural and serum NT-proBNP measures were closely correlated. An NT-proBNP cut off value of > 5133 pg/mL in pleural fluid had a sensitivity of 51.8%, a specificity of 98.9%, respectively (P=0.000, diagnostic accuracy 84.1%) for discriminating transudates caused by heart failure from exudates. Conclusions: Pleural fluid NT-proBNP measurement in the routine diagnostic panel may be useful in differentiation of heart-failure-related pleural effusions and exudative pleural fluids with reasonable accuracy, especially in heart-failure patients treated with diuretics.

Anahtar Kelimeler

NT-proBNP, pleural effusion, heart failure

Kaynakça

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