Bozok Tıp Dergisi

2146-4006 2148-2438

Yozgat Bozok University

10.16919/bozoktip.653724

Health Care Administration

Sağlık Kurumları Yönetimi

STROK ALT GRUPLARINDA LENFOSİT MONOSİT ORANI VE İNFLAMATUAR BELİRTEÇLERDEKİ DEĞİŞİMİN DEĞERLENDİRİLMESİ Evaluation of Changes in Lymphocyte to Monocyte Ratio and İnflammatory Markers in Stroke Subgroups

Çaltekin

İbrahim

BOZOK ÜNİVERSİTESİ Gökçen

Emre

BOZOK ÜNİVERSİTESİ

03 25 2020

10 1 190 195 03 01 2020

2015

Bozok Medical Journal

ÖZETAmaç: Stroke dünya genelinde ciddi morbidite ve mortalite oluşturan hastalıkların başında gelmektedir.Stroke olgularında hematolojik inflamatuar belirteçlerde değişiklik geliştiğini gösteren bazı çalışmalar vardır.Lenfosit monosit oranı (LMO) ise son zamanlarda gündeme gelen özellikle düşük düzeyi ile birçok malignitedeincelenmiş yeni bir hematolojik inflamatuar belirteç olarak kabul edilmektedir. Çalışmamızda acilservisimize nörolojik bulgular ile başvuran ve stroke tanısı alan hastalarda LMO düzeylerini ve klinik sınıflandırmaolan Oxfordshire Community Stroke Project (OCSP) sınıflamasına göre subgruplarda LMO düzeyleriniaraştırmayı amaçladık.Gereç ve Yöntemler: Bir üniversite hastanesinin acil servisine Ocak 2017 - Ocak 2019 tarihleri arasında nörolojikbozukluk semptomları ile başvuran ve iskemik inme tanısı alan hastalar geriye dönük olarak incelenmiştir.Stroke hastaları OCSP classificationa göre subgruplara ayrılmış ve klinik ile görüntüleme sonuçlarıkorele edilmiştir. Tüm gruplarda hematolojik inflamatuar belirteçler incelenmiş, LMO’ daki değişimler tespitedilmiştir.Bulgular: Çalışmamıza 109 (63 bayan, 46 erkek) iskemik stroke hastası, 110 (45 bayan, 65 erkek) kontrolhastası dahil edilmiştir. LMO değeri düşüklüğü strok olgularında kontrol grubuna göre istatistiksel olarakanlamlı bulundu (p<0.05). LMO değeri düşüklüğü her dört gruptada kontrol grubuna göre istatistiksel olarakanlamlı bulundu (p<0.05). TACI ve POCI gruplarında LMO’ da en düşük ortalamalar saptandı. Nötrofil lenfositoranı ve gama glutamil transferaz (GGT) değerleri yüksekliği ise yine her dört grupta da kontrol grubuna göreistatistiksel olarak anlamlı bulundu (p<0.05).Sonuç: Çalışmamızda stroke subgruplarında kısıtlı inceleme yapılan LMO değeri stroke ve subgruplarının tamamındadüşük olarak tespit edilmiştir. Özellikle TACI ve POCI gibi geniş enfarkt alanına sahip klinik durumlardaen düşük seviyedeki ortalamalara ulaşılmıştır. LMO’ nın hem stroke hemde subgruplarda mortalite,morbidite ve prognoz belirleyicisi olarak kullanılabileceği düşünülmektedir.Anahtar kelimeler: Acil servis; İskemik inme; Lenfosit monosit oranıABSTRACTBackround: Stroke is one of the most important disease causing serious morbidity and mortality worldwide.There are some studies showing the change in hematological inflammatory markers in stroke patients.Lymphocyte to monocyte ratio (LMR) is considered to be a new hematological inflammatory marker thathas been recently investigated in many malignancies with its particularly low level. In this study, we aimed toevaluate the levels of LMR in patients presented to our emergency department with neurological findings,diagnosed as ischemic stroke and also we aimed to evaluate the levels of LMR in subgroups according to theOxfordshire Community Stroke Project (OCSP) classification which is a clinical classification.Material and Methods: The patients admitted to the emergency department of a university hospital withsymptoms of neurological disorders and diagnosed with ischemic stroke between January 2017 and January2019 were retrospectively analyzed. Stroke patients were divided into subgroups according to OCSP classificationand clinical and imaging results were correlated. Hematologic inflammatory markers were examinedin all groups and changes in LMR were detected.Results: 109 (63 female, 46 male) ischemic stroke patients and 110 (45 female, 65 male) control patientswere included in the study. The low LMR values were found to be statistically significant in stroke casescompared to the control group (p <0.05). The low LMR values were found to be statistically significant in allfour subgroups compared to the control group (p <0.05). TACI and POCI groups showed the lowest mean inLMR values. Higher NLR and GGT values were found to be statistically significant in all four groups comparedto the control group (p <0.05).Conclusion: In our study, the LMR value, which was limited investigated in stroke subgroups, was found tobe low in all stroke and subgroups. Especially in clinical situations with large infarct sizes such as TACI andPOCI groups, the lowest means were reached. It is thought that LMR can be used as a predictor of mortality,morbidity, and prognosis in both stroke and its subgroups.Keywords: Emergency department; Ischemic stroke; Lymphocyte to monocyte ratio

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