NT-proBNP Changes in Patients with Ascites during Large Volume Paracentesis.

ISRN hepatology Pub Date : 2013-09-22 eCollection Date: 2013-01-01 DOI:10.1155/2013/959474

Vi Nguyen, Rob Zielinski, Paul Harnett, Katherine Miller, Henry Chan, Nikitha Vootakuru, Priya Acharya, Montaha Khan, Oliver Gibbs, Sarika Gupta, Anjla Devi, Shani Phillips, Jacob George, David van der Poorten

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Abstract

Background. N-terminal probrain natriuretic peptide (NT-proBNP) is a hormone involved in the regulation of cardiovascular homeostasis. Changes in serum NT-proBNP during large volume paracentesis (LVP) in patients with ascites have never before been examined. Aims. To determine if significant changes in serum NT-proBNP occur in patients undergoing LVP and the associated clinical correlates in patients with cirrhosis. Method. A total of 45 patients with ascites were prospectively recruited. Serum NT-proBNP, biochemistry, and haemodynamics were determined at baseline and at key time points during and after paracentesis. Results. 34 patients were analysed; 19 had ascites due to cirrhosis and 15 from malignancy. In those with cirrhosis, NT-proBNP decreased by 77.3 pg/mL at 2 L of drainage and 94.3 pg/mL at the end of paracentesis, compared with an increase of 10.5 pg/mL and 77.2 pg/mL in cancer patients at the same time points (P = 0.05 and P = 0.03). Only congestive cardiac failure (CCF) was an independent predictor of significant NT-proBNP changes at the end of drainage in cirrhotic patients (P < 0.01). There were no significant changes in haemodynamics or renal biochemistry for either group. Conclusion. Significant reductions in serum NT-proBNP during LVP occur in patients with cirrhosis but not malignancy, and only comorbid CCF appeared to predict such changes.

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腹水患者在大容量腹腔穿刺过程中的 NT-proBNP 变化

背景。N 端脑钠肽 (NT-proBNP) 是一种参与调节心血管稳态的激素。以前从未研究过腹水患者在大容量腹腔穿刺术（LVP）过程中血清 NT-proBNP 的变化。研究目的确定接受大容量腹腔穿刺术的肝硬化患者血清 NT-proBNP 是否发生明显变化，以及相关的临床关联性。方法。前瞻性地招募了 45 名腹水患者。在基线以及腹腔穿刺过程中和之后的关键时间点测定血清 NT-proBNP、生化指标和血液动力学指标。结果共对 34 名患者进行了分析，其中肝硬化腹水患者 19 名，恶性肿瘤腹水患者 15 名。肝硬化患者在引流 2 L 腹水时，NT-proBNP 下降了 77.3 pg/mL，在腹腔穿刺结束时下降了 94.3 pg/mL，而癌症患者在相同时间点分别上升了 10.5 pg/mL 和 77.2 pg/mL（P = 0.05 和 P = 0.03）。只有充血性心力衰竭（CCF）是肝硬化患者引流末期 NT-proBNP 显著变化的独立预测因素（P < 0.01）。两组患者的血液动力学和肾脏生化指标均无明显变化。结论肝硬化患者在 LVP 期间血清 NT-proBNP 会显著降低，而恶性肿瘤患者不会，只有合并有 CCF 的患者才会出现这种变化。

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ISRN hepatology

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