호중구감소증 환아에서 procalcitonin과 proBNP의 예후 인자로서의 의미

호중구감소증 환아에서 procalcitonin과 proBNP의 예후 인자로서의 의미

Prognostic implications of procalcitonin and proBNP in neutropenic patients

(구연):
Release Date : 2009. 10. 23(금)
Sun Young You, Ji Hye Shin, Sun Young KIm
Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
유선영, 신지혜, 김선영
충남의대 소아과

Abstract

Background; Procalcitonin ( PCT) has been increasingly used as an inflammatory marker to identify patients with systemic infection. N-terminal pro brain natriuretic peptide (NT-proBNP) elevation can be used to predict future cardiac events and survival. The aim of this study was to evaluate the role of PCT and NT-proBNP measurements in febrile neutropenic patients in terms predicting outcomes in these patients. Methods; Neutropenia was defined as neutrophil count of 500 cells/mm3 or less or a count of 1,000 cells/mm3 with a predicted decrease to 500 cells/mm3. Fever in a neutropenic patient is defined as a single measurement of oral temperature of more than 38.3 ℃ or a temperature of 38.0 ℃ for 1 hr. From July 2008 and May 2009, immunocompromized patients with neutropenia were screened for PCT, NT-proBNP at the time of diagnosis, 3 days later and 3 days after fever subsided. Results; A total of 32 patients aged between 2.5 and 13.5 years (17 boys and 15 girls) were admitted because of neutropenic fever at the Chungnam National University Hospital. PCT levels were not significantly different among 3 different times of measurements, but NT-proBNP was significantly higher at 3 days after admission compared with those of at diagnosis and after fever was subsided. PCT and NT-proBNP levels at the time of diagnosis were significantly correlated with each other. Three patients with higher NT-proBNP showed symptoms of heart failure and arrhythmia but PCT was not significantly elevated in these patients. Conclusion; PCT and NT-proBNP at the time of diagnosis were correlated with each other. PCT levels were not significantly changed among 3 different times of measurements but NT-proBNP was significant index of heart failure especially 3 days after fever developed.

Keywords: procalcitonin, proBNP, neutropenia