Akut Pulmoner Emboli Hastalarında Monosit/HDL Oranının Kısa Dönem Mortaliteyi Ön Gördürmedeki Prognostik Değeri

Yıl 2016, Cilt: 19 Sayı: 3, 149 - 153, 01.12.2016

Tolga Han Efe Engin Deniz Arslan Ahmet Göktuğ Ertem Çağrı Yayla Mehmet Ali Felekoğlu Saadet İnci Tolga Çimen Hilal Erken Pamukcu Macit Aydın Murat Bilgin Ekrem Yeter

Öz

Giriş:  Pulmoner emboli
yüksek mortalite ve morbidite oranları ile giden akut acil bir durumdur.
Monosit/yüksek yoğunluklu lipoprotein (HDL) oranının, inflamasyon ve oksidatif
stresin yeni bir belirteci olabileceği, ayrıca bazı kardiyovasküler
hastalıkların varlığı ve prognozu ile de yakından ilişkili olduğu
gösterilmiştir. Pulmoner emboli fizyopatolojisinde inflamasyon ve oksitadif
stres önemli bir rol oynamaktadır. Çalışmanın amacı akut pulmoner emboliden
monosit/HDL oranının kısa dönemde prognostik değerini belirlemektir.

Hastalar
ve Yöntem: Acil servise başvuran ve akut
pulmoner emboli tanısı çok kesitli bilgisayarlı tomografi ile teyit edilen 99
hasta çalışmaya retrospektif olarak dahil edildi.

Bulgular: Pulmoner emboli tanısı alan 99 hastanın, tanı aldıktan
sonra 26 (%25.2)’sı bir ay içinde eksitus oldu. Hastalar, tanı sonrası bir ay
içinde ölenler (1. grup) ve hayatta kalanlar (2. grup) olmak üzere iki gruba
ayrıldı. Yaş, malignite, koroner arter hastalığı, sağ ventrikül fonksiyon
bozukluğu, beyaz kan hücresi, nötrofil, lenfosit, trombosit ve monosit
sayımları, sistolik pulmoner arter basıncı, diyastolik kan basıncı,
nötrofil/lenfosit oranı,  monosit/HDL
oranı, basitleştirilmiş pulmoner emboli ciddiyet indeksi 1. grupta 2. gruba
göre anlamlı derecede yüksek bulundu. Monosit/HDL oranı, nötrofil/lenfosit
oranı ve basitleştirilmiş pulmoner emboli ciddiyet indeksi akut pulmoner emboli
tanısı almış hastalarda mortalitenin bağımsız bir belirleyicisi olduğu görüldü.

Sonuç: Monosit /HDL oranı, pulmoner emboli sonrası erken
dönemde mortalite gelişen hastalarda, mortalite gelişmeyenlere göre daha
yüksekti. Bu nedenle, monosit/HDL oranı gibi ucuz ve pratik bir parametre akut
pulmoner embolide mortalite risk tahmininde kullanılabilir.

Anahtar Kelimeler

Monosit/HDL oranı, pulmoner emboli, mortalite

The Prognostic Value of the Monocyte/HDL Ratio in Predicting Short-term Mortality in Patients with Acute Pulmonary Embolism

Öz

Introduction:
Pulmonary embolism is an acute emergency with high mortality and morbidity
rates. The monocyte/high-density lipoprotein (HDL) ratio was suggested as a new
marker of inflammation and oxidative stress. In addition, the monocyte/HDL
ratio has been shown to be closely related with the presence and prognosis of
some cardiovascular diseases. Inflammation and oxidative stress play an
important role in the pathophysiology of pulmonary embolism. The aim of the
present study was to determine the prognostic value of the monocyte/HDL ratio
in determining the short-term mortality for patients with acute pulmonary
embolism.

Patients
and Methods: Ninety-nine patients who were admitted to the
emergency department and diagnosed with acute pulmonary embolism, which was
confirmed by multidetector computed tomography, were included in this
retrospective study.

Results:
Of the 99 patients, 26 (25.2%) died within 1 month
after the diagnosis was made. Patients were divided into two groups as
survivors (group 1) and (group 2) within 1 month after diagnosis. Age;
malignancy; coronary artery disease; right ventricular dysfunction; white blood
cell, neutrophil, lymphocyte, platelet and monocyte counts; systolic pulmonary
artery pressure, diastolic blood pressure, neutrophil/lymphocyte ratio,
monocyte/HDL ratio and simplified pulmonary embolism severity index were significantly
higher in group 1 (patients died within 1 month after diagnosis) than those in
group 2. The monocyte/HDL ratio, neutrophil/lymphocyte ratio, right ventricle
dysfunction and simplified pulmonary embolism severity index were independent
predictors of mortality in patients with acute pulmonary embolism.

Conclusion:
The
monocyte/HDL ratio, neutrophil/lymphocyte ratio, right ventricle dysfunction
and simplified pulmonary embolism severity index were independent predictors of
mortality in patients with acute pulmonary embolism.

Anahtar Kelimeler

Monocyte/HDL ratio, pulmonary embolism, mortality

Kaynakça

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