Akut Koroner Sendromlu Hastalarda Nötrofil/Lenfosit Oranı ve Monosit Sayımının Değerlendirilmesi

Year 2018, Volume: 18 Issue: 3, 345 - 354, 28.09.2018

İsmail Erkan Aydın Şervan Gökhan Alp Şener Fatih Tanrıverdi Gül Pamukçu Günaydın Gülhan Kurtoğlu Çelik

https://doi.org/10.17098/amj.461436

Cited By: 2

Abstract

Amaç: Akut koroner
sendromlar, dünyada ve ülkemizde tüm ölüm sebepleri içerisinde en üst sırada
yer almaktadır. Bu çalışmada tam kan sayımı parametrelerinin akut koroner
sendromların klinik seyrinde prediktif açıdan değerli olup olmadığını
araştırmak amaçlanmıştır.
Materyal ve Metot: Çalışma, yıllık
hasta sayısı 150.000 olan bir Eğitim ve Araştırma Hastanesi Acil Tıp
Kliniği’nde 01.02.2017-31.07.2017 tarihleri arasında tek merkezli prospektif
olarak gerçekleştirildi. Çalışma için Lokal Klinik Araştırmalar Etik
Kurulu’ndan etik onayı alındı. Hastaların demografik özellikleri, tam kan
parametreleri, nötrofil / lenfosit oranı (NLR), GRACE risk skorları kayıt
altına alındı. Hastaların hastanede kalış süreleri, hastane içi mortaliteleri
ve 6 aylık mortaliteleri takip edildi.
Bulgular: Çalışmadaki hastaların
%77,27’ ü erkek, %22,73’ si kadındı. Yaş ortalaması 61±12 idi. Tüm gruplar
içerisinde NLR değerleri (p=0,009), monosit sayıları (p<0,001) arasında
hastane içi mortalite açısından anlamlı fark saptandı. NLR değerleri (p=0,045),
monosit sayıları (p=0,026) arasında da 6 aylık mortalite açısından anlamlı fark
saptandı. Hastane içi mortalite açısından NLR düzeyi düşük grup ile diğer
gruplar arasında anlamlı fark saptanmıştır (p=0,006), Bu çalışmada NLR alt
grupları arasında 6 aylık mortalite açısından anlamlı fark saptanmamıştır
(p=0,131). GRACE skoru ve NLR arasında zayıf (p<0,001; rho=0,393) korelasyon
saptandı.
Sonuç: Akut koroner sendrom
nedeniyle acil servislerde takip edilen hastalarda tam kan parametreleri ve NLR
gibi parametreler klinik karar verme sürecinde ve hastaların prognozunu ve
mortalitelerini öngörmede yardımcı olabilir.

Keywords

Akut koroner sendrom, nötrofil, lenfosit, monosit, nötrofil/lenfosit oranı

The Evaluation of Neutrophil/Lymphocyte Rates and Monocyte Counts in Patients with Acute Coronary Syndrome

Abstract

Objectives: Acute coronary
syndromes are at the top of all causes of death in the world and in our
country. In this study, we aimed to evaluate whether total blood count
parameters have predictive value in clinical course of acute coronary
syndromes.
Materials and Methods: The study was
performed as a single center prospective study between 01.02.2017 and
31.07.2017 at the Emergency Medicine Clinic of a Training and Research Hospital
in which the annual number of patients is 150,000. Ethics approval was obtained
from the Local Clinical Research Ethics Committee for the study. Demographic
feature, total blood count parameter, neutrophil / lymphocyte ratio (NLR),
GRACE risk score of the patients were recorded. Length of stay, in-hospital
mortality and 6-month mortality of the patients were followed.
Results: In this study, 77.27% of
the patients were male and 22.73% were female. The mean age was 61 ± 12. There
were significant differences between NLR’s (p = 0.009) and monocyte counts (p
<0.001) in all groups in terms of in-hospital mortality. There were also
significant differences between NLR’s (p = 0,045) and monocyte counts (p =
0,026) in terms of 6-month mortality. There was a significant difference
between the group with low NLR and the other groups in terms of hospital
mortality (p = 0,006). There was no significant difference between NLR
subgroups in terms of 6-month mortality in this study (p = 0.131). There was a
weak correlation between GRACE score and NLR (p <0.001; rho = 0.393).
Conclusion: Parameters such as total
blood count and NLR in patients followed up in emergency departments due to
acute coronary syndrome may help in the clinical decision making process and
predicting the prognosis and mortality of patients.

Keywords

Acute coronary syndrome, neutrophil, lymphocyte, monocyte, neutrophil / lymphocyte ratio

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