Serum prolidaz, palyatif bakım hastalarında bası ülserleri için prediktif bir biyobelirteç olabilir mi?

Abstract

Giriş: Prolidaz, inflamasyon, doku hasarı, yara iyileşmesi ve benzeri birçok durumda rol oynayan bir belirteçtir. Basınç ülserleri (BÜ), palyatif bakım servislerinde yatan hastalarda yaygın olarak görülen ve morbidite ile mortaliteyi artıran önemli durumlardır. Bası yaralarının şiddetinin öngörülmesi, izlem ve tedavi açısından oldukça önemlidir. Prolidazın bu tür yaralarla olan ilişkisinin klinik fayda sağlaması mümkündür. Hastalar ve yöntemler: Çalışmaya palyatif bakım ünitesinde yatan 76 hasta dahil edilmiştir. Hastalar, basınç ülserinin varlığına ya da yokluğuna göre iki gruba ayrılmıştır. Kontrol grubu, bası ülseri olmayan grup olarak tanımlanmıştır. Hafif ve şiddetli BÜ olan hastalar ise ayrı gruplarda değerlendirilmiştir. Tüm hastaların C-reaktif protein (CRP) ve Prolidaz düzeyleri ölçülmüştür. Yaraların enfekte olmadığını teyit etmek amacıyla prokalsitonin düzeyi de değerlendirilmiştir. Bulgular: Basınç ülseri olan grupta, olmayan gruba kıyasla prolidaz ve CRP düzeyleri anlamlı derecede yüksek bulunmuştur. Hafif ve şiddetli yaraları olan hastalar karşılaştırıldığında, şiddetli grup daha yüksek CRP ve prolidaz düzeylerine sahipti. Sonuç: Bu öncü çalışma, palyatif bakım servisinde yatan BÜ’lü hastalarda prolidazın bası yaralarının takibi ve ilerleyişinde bir belirteç olarak kullanılabileceğini göstermiştir.

Keywords

• prolidaz
• bası ülseri
• C-reaktif protein
• palyatif bakım
• prokalsitonin

Potential role of serum prolidase as a biomarker in predicting pressure ulcers among palliative care patients

Abstract

Aims: Prolidase is a marker that plays a role in inflammation, collagen turnover, tissue damage, wound healing and many similar conditions. Pressure ulcers (PU) are common among palliative care patients and increase morbidity and mortality. Predicting the severity of PU is very important for follow-up and treatment. It is possible that the association of prolidase with such wounds will provide clinical benefit. Methods: The prospective cross-sectional study included 76 hospitalized patients in a palliative care unit between 2019 and 2020. Patients were divided into two groups: with PU and without PU (controls). PU patients were classified into mild (stages I–II) and severe (stages III–IV). Serum prolidase level, C-reactive protein (CRP), and procalcitonin were measured. Results: Patients with PU had significantly higher prolidase and CRP levels compared with controls. Severe PU patients had higher prolidase and CRP than mild PU patients. Procalcitonin levels were low and similar across groups. A positive correlation was found between prolidase, CRP, and PU severity. Conclusion: Serum prolidase level may be a useful biomarker reflecting PU severity in palliative care patients. Further largescale prospective studies are needed.

Keywords

• Prolidase
• pressure ulcer
• C-reactive protein
• palliative care
• procalcitonin

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