부산대학교 도서관

IntroductionAcute bronchiolitis is the most common lower respiratory tract disease seen during infancy. It has been reported that although the frequency is not fully known, cardiac involvement may develop at [...]
Introduction: We have limited information about the clinical importance of plasma B-type natriuretic peptide (BNP) level and its prognostic value in children with bronchiolitis. In this study, we aimed to determine basal plasma BNP levels and their relationship with left ventricular systolic functions and prognosis in patients hospitalized with moderate to severe bronchiolitis.Methods: The study was conducted prospectively on 37 patients aged 1-24 months with a modified Wang respiratory score of 6 and above and diagnosed with bronchiolitis. The patients with high (>100 pg/mL, n=6) and normal ([less than or equal to]100 pg/mL, n=31) serum BNP levels were compared in terms of left ventricular systolic functions, and vital, laboratory, and radiological findings. The relationship between serum BNP level and prognosis was evaluated.Results: The mean basal plasma BNP level in the patients was significantly higher than in controls (61.75[+ or -]65 pg/mL vs. 13.99[+ or -]8.79 pg/mL; p=0.001). There was no significant difference in ejection fraction and fractional shortening values between the patients with normal and high BNP levels and controls (p>0.05). Patients with high BNP levels had higher mean partial carbon dioxide values than patients with normal BNP levels (p=0.037). There was a positive correlation between plasma BNP level and length of hospital stay (r=0.286; p=0.007) and intensive care unit stay (r=0.645; p=0.000).Conclusion: An increase in serum BNP levels may be seen in patients with moderate to severe bronchiolitis without myocardial dysfunction. It was argued that this BNP increase may be related to the degree of deterioration of gas exchange associated with the disease. Plasma BNP level is a potential prognostic factor in moderate to severe bronchiolitis.Keywords: Bronchiolitis, infant, B-type natriuretic peptide, myocardial dysfunction, prognosisGiris: Bronsiyolitli hastalarda plazma B tipi natriuretik peptid (BNP) duzeyinin klinik onemi ve hastalik seyri ile iliskisi konusunda bilgimiz sinirlidir. Bu calismanin amaci orta-agir bronsiyolit tanisi ile hastaneye yatirilan ve eslik eden baska hastaligi olmayan hastalarin bazal plazma BNP degerleri ile sol ventrikul sistolik fonksiyonlari ve hastalik prognozu arasindaki iliskiyi arastirmaktir.Yontemler: Calismada bronsiyolit tanisi alan, modifiye Wang solunum skoru [greater than or equal to]6 olan, 1-24 ay arasindaki 37 hasta ileriye donuk olarak incelendi. Plazma BNP duzeyi yuksek (>100 pg/mL, n=6) ve normal ([less than or equal to]100 pg/mL, n=31) olan hastalar sol ventrikul sistolik islevleri, yasamsal bulgular, laboratuvar sonuclari ve radyolojik bulgular acisindan karsilastirildi. Plazma BNP duzeyi ile prognoz arasindaki iliski degerlendirildi.Bulgular: Hastalarin ortalama plazma BNP duzeyi, saglikli kontrol grubundan yuksek saptandi (61,75[+ or -]65 pg/mL'ye karsilik 13,99[+ or -]8,79 pg/mL, p=0,001). Plazma BNP duzeyi normal ve yuksek olan hastalar ile saglikli kontrol grubunun ejeksiyon fraksiyonu ve fraksiyonel kisalma degerleri arasinda fark saptanmadi (p>0,05). Plazma BNP duzeyi yuksek olan hastalarin ortalama kismi karbondioksit basinci degeri, BNP duzeyi normal olan hastalardan yuksek bulundu (p=0,037). Plazma BNP duzeyi ile hastanede yatis suresi (r=0,286; p=0,007) ve yogun bakimda yatis suresi (r=0,645; p=0,000) arasinda pozitif bir korelasyon saptandi.Sonuc: Orta-agir bronsiyolitli hastalarda miyokard islev bozuklugu olmaksizin plazma BNP artisi gorulebilir. Bu artis, hastaliga bagli pulmoner gaz degisimindeki bozulmanin derecesi ile iliskili olabilir. Plazma BNP duzeyi, orta-agir bronsiyolitli hastalarda hastalik seyrini ongormede potansiyel bir biyobelirtectir.Anahtar Kelimeler: Bronsiyolit, bebek, B-tipi natriuretik peptid, miyokard disfonksiyonu, prognoz