Akut miyokard infarktüsü seyrinde periferik kök hücre ve beyaz küre sayımının ekokardiyografik ve klinik parametreler ile korelasyonu

Year 2022, , 149 - 157, 01.01.2022

Özgür Taşköylü , Taner Değirmenci , Halil Tanrıverdi

https://doi.org/10.31362/patd.1015020

Abstract

Amaç: İnflamasyon aterosklerozun ve klinik komplikasyonlarının önemli bir komponentidir. Bu sebeple; akut miyokard infarktüsü seyrinde inflamatuvar belirteçlerin kullanımı giderek önem kazanmaktadır. Lökositler bu inflamatuvar süreçte belirgin rol oynamaktadır. Son dönemde akut miyokard infarktüsü seyrinde kök hücre infüzyonu tedavileri yoğun bir şekilde incelenmiştir. Bu çalışmada farklı olarak; spontan periferik kök hücre mobilizasyonun ve beyaz küre altgrup sayımlarının; akut miyokard infarktüsü sonrası sol ventrikül fonksiyonlarındaki düzelme ile ilişkisinin ekokardiyografik olarak incelenmesi amaçlanmıştır.
Gereç ve yöntem: Çalışmamıza akut miyokard infarktüsü nedeniyle kliniğimize başvuran 28 hasta dahil edilmiştir. Yirmi hastaya primer PKG uygulanmış olup 8 hastaya t-PA infüzyonu yapılmıştır.
Bulgular: Lenfosit değerlerinin AMI seyrinde düşüş gösterdiği ve 30. gün kontrollerinde de düşük olarak saptandığı görülmüştür. Bazal lenfosit sayımları CK-MB ile güçlü ve troponin-I ile orta düzeyde negatif korele olarak saptanmıştır (r = -0,668, p=0,001 ve r = -0,465, p=0,01). Lenfosit düzeyleri ile SVEF arasında pozitif korelasyon saptanırken DHSİ ile negatif korelasyon saptanmıştır (r= 0,403, p=0,03 ve r=-0,598, p=0,01). CD34 (+) kök hücre düzeyleri ile SVEF deki değişim arasında pozitif korelasyon saptanmıştır ( r=0,585, p=0,005) CD34 (+) kök hücre düzeyleri ile DHSİ deki değişim arasında orta düzeyde negatif korelasyon saptanmıştır (r=-0,562, p=0,008). AMİ seyri sırasında; periferik lenfosit düzeylerinin SVEF, DHSİ değerlerindeki değişimler ve kardiyak enzim ile korele olduğu saptanmıştır. Periferik CD34 (+) kök hücre düzeyleri ise SVEF, DHSİ gibi ekokardiyografik parametreler ile korele olarak saptanmıştır.
Sonuç: Verilerimiz; lenfositlerin AMI seyrinde aktif rollerinin olduğunu ve lenfopeni düzeylerinin biyomarker olarak kullanılabileceğini düşündürmektedir.

Keywords

Akut miyokard infarktüsü, lenfosit, kök hücre

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