بررسي ارزش تشخيصي اسيد اوريك و PRO BNP در تشخيص فشارخون ريوي در بيماران اسكلرودرمي

Evaluation of Diagnostic Value of Pro BNP and Uric Acid of Pulmonary Arterial Hypertension in Patients with Sclerederma

با توجه به اهميت تشخيص زودهنگام هايپرتنشن شريان ريوي (PAH) در بيماران اسكلرودرمي و شناخت روش هاي غيرتهاجمي و در دسترس، مطالعه حاضر با هدف بررسي رابطه بين سطح سرمي اوريك اسيد و pro-BNP با PAH در بيماران اسكلرودرمي انجام شد. روش كار مطالعه به صورت كنترل-موردي بر روي 112 بيمار مبتلا به اسكلرودرمي مراجعه كننده به بخش روماتولوژي بيمارستان گلستان اهواز در سال 1397 انجام شد. بيماران در دو گروه داراي هايپرتنشن ريوي (فشار سيستوليك شريان پولمونر بيشتر mmHg 40) (38=n) و بدون هايپرتنشن ريوي (بدون علائم PAH) (74=n) وارد مطالعه شدند. از تمام بيمارانcc 5 خون وريدي جهت ارزيابي سطوح سرمي pro-BNP و اوريك اسيد گرفته شد. نتايج ميانگين سطح سرمي اوريك اسيد در گروه اسكلرودرمي با PH به طور معنادار بيشتر بود (05/0>P). اگرچه سطح سرمي pro-BNP در گروه اسكلرودرمي با PH بيشتر بود اما دو گروه از نظر آماري تفاوت معنادار نداشتند (05/0

Background and Objective: Because of the importance of early detection of pulmonary arterial hypertension (PAH) in scleroderma patients and identification of noninvasive and available methods for this purpose, the present study aimed to investigate the relationship between serum uric acid and pro-BNP levels with PAH in scleroderma patients. Subjects and Methods: This case-control study was performed on 112 patients with scleroderma referred to rheumatology department of Ahvaz Golestan Hospital in year 2018. Patients enrolled to the study were divided into two groups: those with pulmonary hypertension (pulmonary artery systolic pressure greater than 40 mmHg) (n=38) and without pulmonary hypertension (no PAH symptoms) (n=74). To evaluate serum levels of pro-BNP (Give full name please) and uric acid, 5 ml of venous blood samples were taken from all patients. Results: Mean serum uric acid level was significantly higher in the PAH group (P <0.05). Although the serum level of BNP was higher in the PH group, there was no statistically significant difference between two groups (P >0.05). The cut-off point of uric acid and proBNP were 6 (mg/dl) and 80 (pg/ml), respectively. The sensitivity, specificity, positive predictive values and negative predictive values of uric acid for detection of PAH in scleroderma patients were 65.79, 85.13% and 71.59 and 45.83%, respectively. On the other hand, the sensitivity, specificity, positive predictive values and negative predictive values of Pro-BNP for detection of PAH in scleroderma patients were 73.68, 74.32% and 59.57 and 84.62% respectively. Conclusion: The results of this study demonstrated the applicability of Pro BNP and uric acid in screening and diagnosis of pulmonary hypertension in patients with scleroderma