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

Abstract

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.

Keywords

• 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

Abstract

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.

Keywords

• Monocyte/HDL ratio,pulmonary embolism,mortality

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