의식저하를 주소로 내원한 비외상성 환자들에서 뇌중풍을 감별하는데 혈중 생화학 지표인: BNP, d-dimer, MMP-9, S100β의 유용성과 사망에 따른 변화 (The Usefulness and Difference of Serum Biomarkers BNP, d-dimer, MMP- 9, and S100βfor Diagnosing Stroke in Patients with Altered Mental Status)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 20권 / 1호 / 108 ~ 114페이지
· 저자명 : 엄영진, 김미란, 이명호, 박상훈, 손강호, 김양원

초록

Purpose: An altered mental state is a common chief complain
at the emergency departments (EDs). But it is difficult
to find out the reason for this mental change. Serum biomarkers
are an alternative way to diagnose the reason for
mental change. We determined the values of four biomarker
for diagnosing the mental changes of the patients seen
at the ED: BNP, d-dimer, MMP-9 and S100β.
Methods: From September 2007 to March 2008, we
prospectively enrolled 42 adult patients who visited the ED
of Hospital because of an altered mental status. We categorized
the patient’s mental state into 5 steps (alert to
coma), and we took samples of blood at the time of visiting
the ED. We then measured the 4 serum markers. The clinical
records were reviewed to analyze the usefulness of
these 4 serum markers.
Results: We enrolled 42 patients (24 females and 18
males). Thirty-three people were diagnosed with stroke and
7 people were diagnosed to not have stroke. The measurements
of BNP, d-dimer and MMP-9 were on average 136.5
±231.7 pg/mL, 2052.2±2071.8 ng/mL and 294.9±311.7
ng/mL, respectively, and S100βwas mostly measured
below 100 pg/mL. After statistic analysis, only MMP-9 had
diagnostic value for stroke, and BNP & d-dimer had a negative
relation to making the diagnosis of stroke.
Conclusion: MMP-9 is useful for making the different diagnosis
of acute stroke in patients with an altered mental status
at the ER. There is the probability of metabolic causes
for ED patients’depressed mentality when the BNP and ddimer
levels are highly elevated, but further study is needed
to confirm this.

영어초록

Purpose: An altered mental state is a common chief complain
at the emergency departments (EDs). But it is difficult
to find out the reason for this mental change. Serum biomarkers
are an alternative way to diagnose the reason for
mental change. We determined the values of four biomarker
for diagnosing the mental changes of the patients seen
at the ED: BNP, d-dimer, MMP-9 and S100β.
Methods: From September 2007 to March 2008, we
prospectively enrolled 42 adult patients who visited the ED
of Hospital because of an altered mental status. We categorized
the patient’s mental state into 5 steps (alert to
coma), and we took samples of blood at the time of visiting
the ED. We then measured the 4 serum markers. The clinical
records were reviewed to analyze the usefulness of
these 4 serum markers.
Results: We enrolled 42 patients (24 females and 18
males). Thirty-three people were diagnosed with stroke and
7 people were diagnosed to not have stroke. The measurements
of BNP, d-dimer and MMP-9 were on average 136.5
±231.7 pg/mL, 2052.2±2071.8 ng/mL and 294.9±311.7
ng/mL, respectively, and S100βwas mostly measured
below 100 pg/mL. After statistic analysis, only MMP-9 had
diagnostic value for stroke, and BNP & d-dimer had a negative
relation to making the diagnosis of stroke.
Conclusion: MMP-9 is useful for making the different diagnosis
of acute stroke in patients with an altered mental status
at the ER. There is the probability of metabolic causes
for ED patients’depressed mentality when the BNP and ddimer
levels are highly elevated, but further study is needed
to confirm this.

참고자료

· 없음