Nötrofil-lenfosit Oranının Hamile Kadınlarda Romatizmal Kalp Kapağı Hastalığını Öngörme Yeteneği

Year 2020, Volume: 10 Issue: 4, 642 - 649, 15.12.2020

Veciha Özlem Bozkaya , Zeynep Asli Oskovi Kaplan , Yaprak Ustun

https://doi.org/10.31832/smj.791258

Abstract

Amaç
Enflamatuar süreçlerin, romatizmal kalp kapağı hastalığı (RKKH) patofizyolojisi üzerinde bir rolü vardır. Enflamatuar bir belirteç olarak nötrofil-lenfosit oranı (NLO), gebelikte bazı klinik durumlarla ilişkilidir. Bu çalışmada, RKKH'li gebelerde NLO'nun prediktif rolünü araştırmayı amaçladık.
Gereç ve Yöntemler
Çalışmaya kardiyoloji polikliniğine sevk edilen ve RKKH tanısı alan (n = 24) birinci trimester gebeler alındı ve kontrol grubu olarak yaşları eşleşen sağlıklı gebeler (n = 24) alındı. İki grup klinik özellikler, ekokardiyografik bulgular ve NLO açısından karşılaştırıldı. NLO’nun RKKH’nı ön görmedeki rolü incelendi.
Bulgular
Gruplar demografik özellikler açısından benzerdi. NLO RKKH'lı kadınlarda kontrol grubuna göre daha yüksekti (3.68 ± 1.74 ve 2.68 ± 1.14, p = 0.00239). NLO (OR: 0,597, p= 0,037, 95% CI: 0,343-0,921) ve nötrofil sayısı (OR: 0,609, p= 0.013, 95% CI: 0,390-0,863) RKKH'nın olası bağımsız prediktörleriydi.
Sonuç
NLO RKKH olan gebe kadınlarda anlamlı olarak daha yüksekti. Tüm hamile kadınlara rutin kardiyak muayene sağlamak mümkün olmadığından; hamilelik sırasında kalp hastalıkları ile ilişkili riskleri azaltmak için spesifik risk grupları için belirteçlerin tanımlanması gerekir. Bu bulgulara göre, yüksek NLO'lı gebe kadınların RKKH gibi KVH açısından daha fazla dikkat göstermeleri gerekebilir. NLO'nın prediktif değerini tanımlamak için geniş hasta gruplarıyla daha ileri çalışmalara ihtiyaç vardır.

Keywords

gebelik, nötrofil-lenfosit oranı, romatizmal kalp kapak hastalığı

THE RELATIONSHIP BETWEEN NEUTROPHIL-LYMPHOCYTE RATIO AND RHEUMATIC HEART VALVE DISEASE IN PREGNANT WOMEN

Abstract

Objective
There is a role of inflammatory processes on the pathophysiology of rheumatic heart valve disease (RHVD). The neutrophil-lymphocyte ratio (NLR) as an inflammatory marker is associated with some clinical situations in pregnancy. In this study, we aimed to investigate the predictive role of NLR in pregnant women with NLR.
Materials and Methods
First-trimester pregnant women, who were referred to cardiology outpatient clinic and diagnosed with RHVD (n=24) were enrolled in this study and age-matched healthy pregnant women (n=24) were taken as control groups. The two groups were compared in terms of clinical characteristics, echocardiographic findings, and NLR. The role of NLO in predicting RKKH has been examined.
Results
Groups were similar in terms of demographic features. NLR was higher in pregnant women with RHVD than the control group (3.68 ±1.74 vs. 2.68±1.14, p=0.00239). NLR (OR: 0,597, p= 0,037, 95% CI: 0,343-0,921) and neutrophil count (OR: 0,609, p= 0.013, 95% CI: 0,390-0,863) were possible independent predictors of RHVD.
Conclusion
NLR was significantly higher among pregnant women with RHVD. As it is not possible to provide routine cardiac check-up to all pregnant women; markers for specific risk groups need to be defined to reduce the risks associated with heart diseases during pregnancy. According to these findings, pregnant women with high NLR may need extra attention in terms of CVD like RHVD. Further studies with large patient groups are needed to define the predictive value of NLR.

Keywords

pregnancy, neuthrophil-lymphocyte ratio, rheumatic heart valve disease

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