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KMID : 0385920090200010108
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Journal of the Korean Society of Emergency Medicine
2009 Volume.20 No. 1 p.108 ~ p.114
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The Usefulness and Difference of Serum Biomarkers BNP, d-dimer, MMP-9, and S100β for Diagnosing Stroke in Patients with Altered Mental Status
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Eom Young-Jin
Kim Mi-Ran
Kim Yang-Weon
Park Sang-Hoon
Lee Myung-Ho
Son Kang-Ho
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Abstract
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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.
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KEYWORD
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Consciousness disorders, Stroke, Biological markers
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