Ortalama Trombosit Hacmi ve Nötrofil Lenfosit Oranı: Preeklampsinin Ciddiyetinin Yeni Belirteçleri

Yıl 2015, Cilt: 18 Sayı: 2, 84 - 88, 03.08.2015

Mehmet Ata Akıl Mehmet Zihni Bilik Halit Acet Senem Yaman Tunç Faruk Ertaş Mesut Aydın Hasan Kaya Yahya İslamoğlu Sait Alan

Öz

Giriş:
Bu çalışmada, hematolojik parametrelerin ölçümleri
ile preeklamptik kadınlarda hipertansiyon şiddetini tahmin etmenin mümkün olup
olmadığını araştırdık.

Hastalar
ve Yöntem: İki yüz altmış bir
preeklamptik ve 51 normal gebe kadın çalışmaya alındı. Preeklampsi olguları
hafif ve ağır preeklampsi olarak sınıflandırıldı.

Bulgular:
Doğum sonrası sonuçlar karşılaştırıldığında,
preeklamptik kadınların trombosit sayıları düşük, ortalama trombosit hacimleri
ve nötrofil lenfosit oranları yüksekti (sırasıyla; p< 0.001, p< 0.001 ve
p< 0.001). Çoklu lineer regresyon analizinde, ortalama trombosit hacmi ve
nötrofil lenfosit oranı hipertansiyon şiddeti ile bağımsız bir şekilde
korelasyon gösterdi (sırasıyla; β= 0.25, p< 0.001 ve β= 0.31, p< 0.001).

Sonuç: Hem 
ortalama trombosit hacmi hemde nötrofil lenfosit oranı preeklamptik
gebelerde hipertansiyonun şiddetini öngörmede bağımsız birer belirleyici olarak
kullanılabilir.

Anahtar Kelimeler

Preeklampsi, ortalama trombosit hacmi, nötrofil lenfosit oranı, hipertansiyon

Mean Platelet Volume and Neutrophil Lymphocyte Ratio as New Markers of Preeclampsia Severity

Öz

Introduction:
This study was undertaken to examine the role of
hematological parameters in predicting the severity of hypertension in
pre-eclamptic women.

Patients
and Methods: Two hundred sixty-one pre-eclamptic women and
fifty-one women with normal pregnancy were included in the study. The severity
of preeclampsia was classified as mild or severe.

Results:
Compared to post-delivery period, pre-eclamptic
females had lower platelet count, raised mean platelet volume and raised
neutrophil lymphocyte ratio (p< 0.001, p< 0.001, p< 0.001,
respectively). Multiple linear regression analysis showed an independent
correlation between the severity of hypertension and mean platelet volume as
well as the neutrophil lymphocyte ratio (β= 0.25, p< 0.001; β= 0.31, p<
0.001, respectively).

Conclusion:
Both mean platelet volume and neutrophil lymphocyte
ratio emerged as independent predictors of the severity of hypertension in
preeclampsia.

Anahtar Kelimeler

Preeclampsia, mean platelet volume, neutrophil lymphocyte ratio, hypertension

Kaynakça

• 1. Brown MA. The physiology of pre-eclampsia. Clin Exp Pharmacol Physiol 1995;22:781-91.
• 2. Redman CW. Immunological aspects of pre-eclampsia. Baillieres Clin Obstet Gynecol 1992;6:601-15.
• 3. Romero R, Lockwood C, Oyarzun E, Hobbins JC. Toxemia: new concepts in an old disease. Semin Perinatol 1988;12:302-23.
• 4. Redman CW. Platelets and the beginnings of preeclampsia. N Engl J Med 1990;323:478-80.
• 5. Redman CW, Bonnar J, Beilin L. Early platelet consumption in pre-eclampsia. Br Med J 1978;1:467-69.
• 6. Polanowska-Grabowska R, Raha S, Gear AR. Adhesion efficiency, platelet density and size. Br J Haematol 1992;82:715-20.
• 7. Järemo P, Lindahl TL, Lennmarken C, Forsgren H. The use of platelet density and volume measurements to estimate the severity of pre-eclampsia. Eur J Clin Invest 2000;30:1113-8.
• 8. Dundar O, Yoruk P, Tutuncu L, Erikci AA, Muhcu M, Ergur AR, et al. Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia. Prenat Diagn 2008;28:1052-6.
• 9. Thombson CB, Eaton K, Princiotta SM, Rushin CA, Valeri CR. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity, and function. Br J Haematol 1982;50:509-19.
• 10. Celik T, Yuksel UC, Iyisoy A, Kursaklioglu H, Ozcan O, Kilic S, et al. Effects of nebivolol on platelet activation in hypertensive patients: a comparative study with metoprolol. Int J Cardiol 2007;116:206-11.
• 11. Park Y, Schoene N, Haris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002;13:301-6.
• 12. Walker JJ, Cameron AD, Bjornsson S, Singer CR, Fraser C. Can platelet volume predict progressive hypertensive disease in pregnancy? Am J Obstet Gynecol 1989;161:676-9.
• 13. Makuyana D, Mahomed K, Shukusho FD, Majoko F. Liver and kidney function tests in normal andpre-eclamptic gestationa comparison with non-gestational reference values. Cent Afr J Med 2002;48:55-9.
• 14. Ceyhan T, Beyan C, Başer I, Kaptan K, Güngör S, Ifran A. The effect of pre-eclampsia on complete blood count, platelet count and mean platelet volume. Ann Hematol 2006;85:320-2.
• 15. Gervasi MT, Chaiworapongsa T, Pacora P, Naccasha N, Yoon BH, Maymon E, et al. Phenotypic and metabolic characteristics of monocytes and granulocytes in preeclampsia. Am J Obstet Gynecol 2001;185:792-7.
• 16. Greer IA, Haddad NG, Dawes J, Johnstone FD, Calder AA. Neutrophil activation in pregnancy-induced hypertension. Br J Obstet Gynaecol 1989;96:978-82.
• 17. Tsukimori K, Maeda H, Ishida K, Nagata H, Koyanagi T, Nakano H. The superoxide generation of neutrophils in normal and preeclamptic pregnancies. Obstet Gynecol 1993;81:536-40.
• 18. Ogburn PL Jr, Williams PP, Johnson SB, Holman RT. Serum arachidonic acid levels in normal and preeclamptic pregnancies. Am J Obstet Gynecol 1984;148:5-9.
• 19. Williams MA, Zingheim RW, King IB, Zebelman AM. Omega-3 fatty acids in maternal erythrocytes and risk of preeclampsia. Epidemiology 1995;6:232-7.
• 20. Bartl W, Bernaschek G, Wagner G, Liszka K. Alterations of immunologic parameters in pregnancies complicated by EPH-gestosis. Biol Res Pregnancy Perinatol 1985;6:73-8.
• 21. Thavaramara T, Phaloprakarn C, Tangjitgamol S, Manusirivithaya S. Role of neutrophil to lymphocyteratio as a prognostic indicator for epithelial ovarian cancer. J Med Assoc Thai 2011;94:871-7.
• 22. Kaya MG. Inflammation and coronary artery disease: as a new biomarker neutrophil/lymphocyte ratio. Turk Kardiyol Dern Ars 2013;41:191-2.