Araştırma Makalesi
Akut orta serebral arter enfarkt hastalarında ile ortalama trombosit hacmi, nötrofil lenfosit oranı ve trombosit lenfosit oranının prediktif değeri
Öz
Amaç: Tıkayıcı beyin damar hastalıklarında ortalama trombosit hacminin arttığı, lenfosit ve nötrofilerin iskemik hasarı artırdığı bilinmektedir. Çalışmamızda akut orta serebral dal enfarkı olan hastalarda ortalama trombosit hacmi, nötrofil lenfosit oranı ve trombosit lenfosit oranının prediktif değerini belirlemeyi amaçladık.
Yöntem: Nisan 2017–Eylül 2019 tarihleri arasında Çanakkale Onsekiz Mart Anestezi ve Reanimasyon yoğun bakımda takip edilen, daha önce iskemik inme geçirmemiş akut orta serebral arter dal tıkanıklığı olan 50 hastanın dosyası geriye dönük olarak incelendi. Hasta grubu ulusal inme sağlık ölçeği skalası (NIHSS) ve Modifiye rankin skoru (mRS) kullanılarak değerlendirildi. İnmenin ilk saatindeki nötrofil ve trombosit sayısının lenfosit sayısına (NLO ve TLO oranı) oranının ve OTH (ortalama trombosit hacmi) düzeylerini Benzer yaş ve cinsiyette kontrol grubu ile karşılaştırdık.
Bulgular: Çalışmamıza akut orta serebral arter dal iskemisi olan 28’i kadın (%56) olmak üzere 50 hasta alındı. Kontrol grubu ise yaşı ve cinsiyetiyle uyumlu 24’ü (%48) kadın 50 sağlıklı kişi alındı. Hastaların ortalama NIHSS skoru 11.4±2.6 ve ortalama mRS skoru 2.5±1.5 idi.
Sonuç: Tıkayıcı beyin damar hastalıklarında hematolojik parametrelerin inmenin şiddeti ve prognozuyla ilişkisini inceleyen birçok çalışma vardır. Akut orta serebral arter dal infarktı geçiren hastalarla yaptığımız bu çalışmada inmenin ilk saatinde bakılan NLO, TLO, OTH düzeyini kontrol grubu ile kıyaslandığında istatiksel olarak anlamlı yüksek bulundu. Hematolojik parametrelerin iskemik inmede bir biyobelirteç olarak kullanılması için çok merkezli daha geniş katılımlı çalışmalara ihtiyaç vardır.
Kaynakça
- 1-Benjamin EJ, Virani SS, Callaway CW, et al.and On behalf of theAmerican Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics—2018 Update: A Report From the American Heart Association. Circulation. 2018;137:e67–e492 2-. Boehme AK, Esenwa C, Elkind MS. Stroke Risk Factors, Genetics, andPrevention. CirculationResearch. 2017;120:472–495.
- 3-Utku U, Çelik Y. İnmedeetiyoloji, sınıflandırmave risk faktörleri. Balkan S (Editör). SerebrovaskülerHastalıklar. 2. baskı. İstanbul: GünesKitabevi; 2005: p.57-72. 4-Gray, C. S. French, J. M., James, O. F, Bates, D, &Cartlıdge, M. E. (1988). Theprognosticvalue of haematocrit in acutestroke. Age andageing, 17(6), 406-409. 5- Talwalkar SS, Bon Homme M, Miller JJ et al. Ischemiamodifiedalbumin, a marker of acuteischemicevents: a pilot study. AnnClinLabSci. 2008; 38 (2):132-7.
- 6-Buyukkaya E, Karakas MF, Karakas E, et al: Correlation of neutrophiltolymphocyteratiowiththe presence andseverity of metabolicsyndrome. ClinApplThrombHemost2014;20:159-63.
- 7-Imtiaz F, Shafique K, Mirza SS, et al: Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med. 2012 Jan 26;5(1):2. doi: 10.1186/1755-7682-5-2.
- 8. BOLAYIR A,BOLAYIR H.A. The Effect of Plateletto Lymphocyte Ratio on Mortality in PatientswithAcuteIntracerebralHemorrhage Bozok Med J 2018;8(1):75-81)
- 9-Kazmierski R, Guzik P, Ambrosius W, Ciesielska A, Moskal J, Kozubski W. Predictivevalue of White bloodcellcount on admissionfor in-hospitalmortality in acutestrokepatients. ClinNeurolNeurosurg2004;107:38-43.
- 10-Beray-Berthat V, Palmier B, Plotkine M, Margaill I. Neutrophils do not contributetoinfarction, oxidativestress, and NO synthaseactivity in severe brainischemia. ExpNeurol2003;182:446-54.
- 11-Güldiken, B., Özkan, H., &Kabayel, L. (2008). Akutiskemikinmedeortalamatrombosithacmiveperiferikkanhücresayısıyanıtı. Balkan MedicalJournal, 2008(2), 130-135.
- 12-Tokgoz S, Keskin S, Kayrak M, Seyithanoglu A, Ogmegul A. Is neutrophil/lymphocyteratiopredicttoshort-termmortality in acutecerebralinfarctindependentlyfrominfarctvolume? J StrokeCerebrovascDis 2014; 23: 2163-8. 13- Schwartz M, Moalem G. Beneficialimmuneactivityafter CNS injury: prospectsforvaccination. J Neuroimmunol 2001; 113: 185-92.
- 14- Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Earlyneutrophilia is associatedwithvolume of ischemictissue in acutestroke. Stroke 2008;39:355- 60.
- 15- Ross AM, Hurn P, Perrin N, Wood L, Carlini W, Potempa K. Evidence of theperipheralinflammatoryresponse in patientswithtransientischemicattack. J StrokeCerebrovascDis2007;16:203-7.
- 16- Pantoni L, Sarti C, Inzitari D. Cytokinesandcelladhesionmolecules in cerebralischemia: experimentalbasesandtherapeuticperspectives. ArteriosclerThrombVascBiol1998;18:503-13.
- 17- Mori E, del ZoppoGJ, Chambers JD, Copeland BR, ArforsKE. Inhibition of polymorphonuclearleukocyteadherencesuppressesno-reflowafterfocalcerebralischemia in baboons. Stroke 1992;23:712-8.
- 18- Beray-Berthat V, Croci N, Plotkine M, Margaill I. Polymorphonuclearneutrophilscontributetoinfarctionandoxidativestress in thecortex but not in the striatum after ischemia-reperfusion in rats. Brain Res 2003;987:32-8.
- 19-Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevatedmeanplateletvolumeassociatedwith a worseoutcome in patientswithacuteischemiccerebrovascularevents? Stroke 2004;35:1688-91.
- 20.Deveci Ş. Çelebi A. Aşkın S. Gürsoy A E ,Kolukısa M ,Hakyemez A.Akutiskemikinmeileortalamatrombosithacmiilişkisi. Egetıpdergisi 2014;53(1):1-6.
- 21.Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease.Stroke. 2004 Mar;35(3):622-6. Epub 2004 Feb 19.
The predictive value of mean platelet volume, neutrophil lymphocyte ratio and platelet lymphocyte ratio in acute middle cerebral artery infarction patients
Öz
Objective: The aim of this study was to determine the predictive value of mean platelet volume (MPV), neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in patients with acute middle cerebral artery (MCA)branch infarction.
Method: This examination was performed on the files of 50 patients followed up at the Anesthesia and Reanimation ICU of Onsekiz Mart University Hospital between April 2017 and September 2019 for acute occlusion in the MCA branch, with no previous history of an ischemic stroke. These patients were assessed with the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Score (mRS). The ratios of the neutrophil and platelet countsto the lymphocyte count (NLR and PLR ratios) within the first hour of the stroke and MPV were compared to a control group.
Results: The study included 50 patients with the acute ischemia of the MCA branch, of which 28 (56%) were female. The control group consisted of 50 healthy people, and 24 (48%) of these were female. The mean NIHSS score of the patients was 11.4 ± 2.6, and their mean mRS was 2.5 ± 1.5.
Conclusions: In our study with patients who had acute middle cerebral artery infarction, we found that the NLR, PLR, and MPV levels within the first hour of stroke were higher in the patient group in comparison to the control group ona statistically significant level. However, multicenter studies with larger subject groups are needed for the use of hematological parameters as biomarkers in an ischemic stroke
Anahtar Kelimeler
cerebral artery infarct mean platelet volume neutrophil lymphocyte
Kaynakça
- 1-Benjamin EJ, Virani SS, Callaway CW, et al.and On behalf of theAmerican Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics—2018 Update: A Report From the American Heart Association. Circulation. 2018;137:e67–e492 2-. Boehme AK, Esenwa C, Elkind MS. Stroke Risk Factors, Genetics, andPrevention. CirculationResearch. 2017;120:472–495.
- 3-Utku U, Çelik Y. İnmedeetiyoloji, sınıflandırmave risk faktörleri. Balkan S (Editör). SerebrovaskülerHastalıklar. 2. baskı. İstanbul: GünesKitabevi; 2005: p.57-72. 4-Gray, C. S. French, J. M., James, O. F, Bates, D, &Cartlıdge, M. E. (1988). Theprognosticvalue of haematocrit in acutestroke. Age andageing, 17(6), 406-409. 5- Talwalkar SS, Bon Homme M, Miller JJ et al. Ischemiamodifiedalbumin, a marker of acuteischemicevents: a pilot study. AnnClinLabSci. 2008; 38 (2):132-7.
- 6-Buyukkaya E, Karakas MF, Karakas E, et al: Correlation of neutrophiltolymphocyteratiowiththe presence andseverity of metabolicsyndrome. ClinApplThrombHemost2014;20:159-63.
- 7-Imtiaz F, Shafique K, Mirza SS, et al: Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med. 2012 Jan 26;5(1):2. doi: 10.1186/1755-7682-5-2.
- 8. BOLAYIR A,BOLAYIR H.A. The Effect of Plateletto Lymphocyte Ratio on Mortality in PatientswithAcuteIntracerebralHemorrhage Bozok Med J 2018;8(1):75-81)
- 9-Kazmierski R, Guzik P, Ambrosius W, Ciesielska A, Moskal J, Kozubski W. Predictivevalue of White bloodcellcount on admissionfor in-hospitalmortality in acutestrokepatients. ClinNeurolNeurosurg2004;107:38-43.
- 10-Beray-Berthat V, Palmier B, Plotkine M, Margaill I. Neutrophils do not contributetoinfarction, oxidativestress, and NO synthaseactivity in severe brainischemia. ExpNeurol2003;182:446-54.
- 11-Güldiken, B., Özkan, H., &Kabayel, L. (2008). Akutiskemikinmedeortalamatrombosithacmiveperiferikkanhücresayısıyanıtı. Balkan MedicalJournal, 2008(2), 130-135.
- 12-Tokgoz S, Keskin S, Kayrak M, Seyithanoglu A, Ogmegul A. Is neutrophil/lymphocyteratiopredicttoshort-termmortality in acutecerebralinfarctindependentlyfrominfarctvolume? J StrokeCerebrovascDis 2014; 23: 2163-8. 13- Schwartz M, Moalem G. Beneficialimmuneactivityafter CNS injury: prospectsforvaccination. J Neuroimmunol 2001; 113: 185-92.
- 14- Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Earlyneutrophilia is associatedwithvolume of ischemictissue in acutestroke. Stroke 2008;39:355- 60.
- 15- Ross AM, Hurn P, Perrin N, Wood L, Carlini W, Potempa K. Evidence of theperipheralinflammatoryresponse in patientswithtransientischemicattack. J StrokeCerebrovascDis2007;16:203-7.
- 16- Pantoni L, Sarti C, Inzitari D. Cytokinesandcelladhesionmolecules in cerebralischemia: experimentalbasesandtherapeuticperspectives. ArteriosclerThrombVascBiol1998;18:503-13.
- 17- Mori E, del ZoppoGJ, Chambers JD, Copeland BR, ArforsKE. Inhibition of polymorphonuclearleukocyteadherencesuppressesno-reflowafterfocalcerebralischemia in baboons. Stroke 1992;23:712-8.
- 18- Beray-Berthat V, Croci N, Plotkine M, Margaill I. Polymorphonuclearneutrophilscontributetoinfarctionandoxidativestress in thecortex but not in the striatum after ischemia-reperfusion in rats. Brain Res 2003;987:32-8.
- 19-Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevatedmeanplateletvolumeassociatedwith a worseoutcome in patientswithacuteischemiccerebrovascularevents? Stroke 2004;35:1688-91.
- 20.Deveci Ş. Çelebi A. Aşkın S. Gürsoy A E ,Kolukısa M ,Hakyemez A.Akutiskemikinmeileortalamatrombosithacmiilişkisi. Egetıpdergisi 2014;53(1):1-6.
- 21.Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease.Stroke. 2004 Mar;35(3):622-6. Epub 2004 Feb 19.
Toplam 17 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 21 Temmuz 2020 |
| Kabul Tarihi | 14 Temmuz 2020 |
| Yayımlandığı Sayı | Yıl 2020 |