Preeklampside Sistemik Enflamatuar Cevap Belirteçleri
Öz
Amaç: Preeklamptik ve sağlıklı gebelerde; sistemik enflamatuar cevap belirteçlerinin değerlendirilmesi ve hastalığı predikte etmedeki etkisinin belirlenmesidir.
Gereç ve Yöntem: Çalışmamız Mart 2017/Mayıs 2019 tarihleri arasında yapılmış, retrospektif bir çalışmadır. Preeklamptik hastalar ile sağlıklı gebelerin verileri hasta dosyalarından ve hastane bilgi yönetim sistemi taranarak elde edildi. Kontrol grubu oluşturulurken PE grubu ile yaş ve VKİ parametrelerinde istatiksel anlamlı farklılık olmamasına dikkat edildi. Gestasyonel diyabetes mellitus, tip I-II diyabetes mellitus, çoğul gebelikler, böbrek hastalıkları, karaciğer hastalıkları, tiroid hastalıkları, kronik enflamatuvar hastalıklar, akut enfeksiyonlar ve kortikosteroid kullanan gebeler çalışma dışı bırakıldı.
Bulgular: Çalışmaya 39 preeklamptik gebe ve 91 sağlıklı gebe dahil edildi. Çalışmaya dahil edilen kadınların yaş ortalaması 30.5±5.26; vücut kitle indeksi ortalaması 27.9±4.28 idi. Gruplar arasında yaş ve vücut kitle indeksi değerleri anlamlı değildi. Parite, sistolik ve diastolik kan basınçları gruplar arasında anlamlı olarak farklıydı. Fakat nötrofil/lökosit oranı (NLR), platelet/lenfosit oranı (PLR) ve lenfosit/monosit oranı (LMR) değerlendirildiğinde gruplar arasında anlamlı bir farklılık saptanmadı.
Sonuç: Çalışmamızda preeklamptik ve sağlıklı grupta sistemik enflamatuar cevap belirteçleri açısından farklılık saptanmamıştır.
Anahtar Kelimeler
Kaynakça
- 1. Wong TY, Groen H, Faas MM, van Pampus MG. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2013;3(4):248-53.
- 2. Erez O, Vardi IS, Hallak M, Hershkovitz R, Dukler D, Mazor M. Preeclampsia in twin gestations: association with IVF treatments, parity and maternal age. The Journal of Maternal-Fetal & Neonatal Medicine. 2006;19(3):141-6.
- 3. Obstetricians ACo, Gynecologists. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstetrics and gynecology. 2013;122(5):1122.
- 4. Pijnenborg R, Vercruysse L, Carter AM. Deep trophoblast invasion and spiral artery remodelling in the placental bed of the chimpanzee. Placenta. 2011;32(5):400-8.
- 5. Redman C, Sargent I. Placental stress and pre-eclampsia: a revised view. Placenta. 2009;30:38-42.
- 6. Myatt L, Webster RP. Vascular biology of preeclampsia. Journal of Thrombosis and Haemostasis. 2009;7(3):375-84.
- 7. Laresgoiti‐Servitje E. A leading role for the immune system in the pathophysiology of preeclampsia. Journal of leukocyte biology. 2013;94(2):247-57.
- 8. Holthe MR, Staff AC, Berge LN, Lyberg T. Different levels of platelet activation in preeclamptic, normotensive pregnant, and nonpregnant women. American journal of obstetrics and gynecology. 2004;190(4):1128-34.
- 9. Özdemirci Ş, Başer E, Kasapoğlu T, Karahanoğlu E, Kahyaoglu I, Yalvaç S, et al. Predictivity of mean platelet volume in severe preeclamptic women. Hypertension in pregnancy. 2016;35(4):474-82.
- 10. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2017;7:29-32.
- 11. Thalor N, Singh K, Pujani M, Chauhan V, Agarwal C, Ahuja R. A correlation between platelet indices and preeclampsia. Hematology, transfusion and cell therapy. 2019;41(2):129-33.
- 12. Altınbas S, Toğrul C, Orhan A, Yücel M, Danısman N. Increased MPV is not a significant predictor for preeclampsia during pregnancy. Journal of clinical laboratory analysis. 2012;26(5):403-6.
- 13. Hassan HE-S, Azzam H, Othman M, Hassan M, Selim T. Soluble E-selectin, platelet count and mean platelet volume as biomarkers for pre-eclampsia. Pregnancy Hypertension. 2019;17:1-4.
- 14. Mor G, Kwon J-Y. Trophoblast-microbiome interaction: a new paradigm on immune regulation. American journal of obstetrics and gynecology. 2015;213(4):S131-S7.
- 15. Steegers EA, Von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. The Lancet. 2010;376(9741):631-44.
- 16. Tarnowska-Mądra U, Leibschang J, Kowalska B, Filipp E, Kozar A, Nimer A, et al. Levels of immunoreactive cytokines in serum of women with preeclampsia or severe pregnancy hypertension. Ginekologia polska. 2010;81(3).
- 17. Vahit D, Akboga MK, Samet Y, Hüseyin E. Assessment of monocyte to high density lipoprotein cholesterol ratio and lymphocyte-to-monocyte ratio in patients with metabolic syndrome. Biomarkers in medicine. 2017;11(7):535-40.
- 18. Yu W, Dou Y, Wang K, Liu Y, Sun J, Gao H, et al. Preoperative neutrophil lymphocyte ratio but not platelet lymphocyte ratio predicts survival and early relapse in patients with oral, pharyngeal, and lip cancer. Head & neck. 2019.
- 19. Westerdijk K, Simons KS, Zegers M, Wever PC, Pickkers P, de Jager CP. The value of the neutrophil-lymphocyte count ratio in the diagnosis of sepsis in patients admitted to the Intensive Care Unit: A retrospective cohort study. PloS one. 2019;14(2):e0212861.
- 20. Yavuzcan A, Caglar M, Ustun Y, Dilbaz S, Yidiz E, Ozbilgec S, et al. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekologia polska. 2014;85(3).
- 21. Gogoi P, Sinha P, Gupta B, Firmal P, Rajaram S. Neutrophil‐to‐lymphocyte ratio and platelet indices in pre‐eclampsia. International Journal of Gynecology & Obstetrics. 2019;144(1):16-20.
- 22. Toptas M, Asik H, Kalyoncuoglu M, Can E, Can MM. Are neutrophil/lymphocyte ratio and platelet/lymphocyte ratio predictors for severity of preeclampsia? Journal of Clinical Gynecology and Obstetrics. 2016;5(1):27-31.
- 23. Serin S, Avcı F, Ercan O, Köstü B, Bakacak M, Kıran H. Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2016;6(1):22-5.
- 24. Abd-Alazim M, Mohammad AH, Radwan MS, Shokr AA. Is Neutrophil/Lymphocyte Ratio A Useful Marker to Predict the Severity of Pre-Eclampsia? Egyptian Journal of Hospital Medicine. 2018;73(5).
- 25. Kholief A, Swilam R, Elhabashy A, Elsherief R. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and c-reactive protein as markers for severity of pre-eclampsia. Research and Opinion in Anesthesia and Intensive Care. 2019;6(1):1.
- 26. Sacks GP, Studena K, Sargent IL, Redman CW. Normal pregnancy and preeclampsia both produce inflammatory changes in peripheral blood leukocytes akin to those of sepsis. American journal of obstetrics and gynecology. 1998;179(1):80-6.
- 27. Steinberg G, Khankin EV, Karumanchi SA. Angiogenic factors and preeclampsia. Thrombosis Research. 2009;123:S93-S9.
- 28. Redman C, Sargent I. Placental debris, oxidative stress and pre-eclampsia. Placenta. 2000;21(7).
- 29. Wang J, Zhu Q-W, Cheng X-Y, Liu J-y, Zhang L-l, Tao Y-M, et al. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. Journal of reproductive immunology. 2019;132:29-34.
Systemic İnflammation Response Markers in Preeclampsia
Öz
Aim: In preeclamptic and healthy pregnant women; the evaluation of systemic inflammatory response markers and determining the effect in predicting the disease.
Material and Method: Our study is a retrospective study conducted between March 2017 / May 2019. The data of preeclamptic patients and healthy pregnant women were obtained by scanning patient files and hospital information management system. While forming the control group, it was paid attention that there was no statistically significant difference for age and BMI parameters between groups. Pregnant women with gestational diabetes mellitus, type I-II diabetes mellitus, multiple pregnancies, kidney diseases, liver diseases, thyroid diseases, chronic inflammatory diseases, acute infections and using corticosteroids were excluded.
Results: Thirty nine preeclamptic pregnant women and 91 healthy pregnant women were included in the study. The average age included women in the study was 30.5 ± 5.26; mean body mass index was 27.9 ± 4.28. Age and body mass index values were not significant between the groups. Parity, systolic and diastolic blood pressures were significantly different between the groups. However, when neutrophil / leukocyte ratio (NLR), platelet / lymphocyte ratio (PLR) and lymphocyte / monocyte (LMR) ratio were evaluated, no significant difference was found between the groups.
Conclusion: In our study, no difference was found in terms of systemic inflammatory response markers in preeclamptic and healthy groups.
Anahtar Kelimeler
Kaynakça
- 1. Wong TY, Groen H, Faas MM, van Pampus MG. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2013;3(4):248-53.
- 2. Erez O, Vardi IS, Hallak M, Hershkovitz R, Dukler D, Mazor M. Preeclampsia in twin gestations: association with IVF treatments, parity and maternal age. The Journal of Maternal-Fetal & Neonatal Medicine. 2006;19(3):141-6.
- 3. Obstetricians ACo, Gynecologists. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstetrics and gynecology. 2013;122(5):1122.
- 4. Pijnenborg R, Vercruysse L, Carter AM. Deep trophoblast invasion and spiral artery remodelling in the placental bed of the chimpanzee. Placenta. 2011;32(5):400-8.
- 5. Redman C, Sargent I. Placental stress and pre-eclampsia: a revised view. Placenta. 2009;30:38-42.
- 6. Myatt L, Webster RP. Vascular biology of preeclampsia. Journal of Thrombosis and Haemostasis. 2009;7(3):375-84.
- 7. Laresgoiti‐Servitje E. A leading role for the immune system in the pathophysiology of preeclampsia. Journal of leukocyte biology. 2013;94(2):247-57.
- 8. Holthe MR, Staff AC, Berge LN, Lyberg T. Different levels of platelet activation in preeclamptic, normotensive pregnant, and nonpregnant women. American journal of obstetrics and gynecology. 2004;190(4):1128-34.
- 9. Özdemirci Ş, Başer E, Kasapoğlu T, Karahanoğlu E, Kahyaoglu I, Yalvaç S, et al. Predictivity of mean platelet volume in severe preeclamptic women. Hypertension in pregnancy. 2016;35(4):474-82.
- 10. Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2017;7:29-32.
- 11. Thalor N, Singh K, Pujani M, Chauhan V, Agarwal C, Ahuja R. A correlation between platelet indices and preeclampsia. Hematology, transfusion and cell therapy. 2019;41(2):129-33.
- 12. Altınbas S, Toğrul C, Orhan A, Yücel M, Danısman N. Increased MPV is not a significant predictor for preeclampsia during pregnancy. Journal of clinical laboratory analysis. 2012;26(5):403-6.
- 13. Hassan HE-S, Azzam H, Othman M, Hassan M, Selim T. Soluble E-selectin, platelet count and mean platelet volume as biomarkers for pre-eclampsia. Pregnancy Hypertension. 2019;17:1-4.
- 14. Mor G, Kwon J-Y. Trophoblast-microbiome interaction: a new paradigm on immune regulation. American journal of obstetrics and gynecology. 2015;213(4):S131-S7.
- 15. Steegers EA, Von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. The Lancet. 2010;376(9741):631-44.
- 16. Tarnowska-Mądra U, Leibschang J, Kowalska B, Filipp E, Kozar A, Nimer A, et al. Levels of immunoreactive cytokines in serum of women with preeclampsia or severe pregnancy hypertension. Ginekologia polska. 2010;81(3).
- 17. Vahit D, Akboga MK, Samet Y, Hüseyin E. Assessment of monocyte to high density lipoprotein cholesterol ratio and lymphocyte-to-monocyte ratio in patients with metabolic syndrome. Biomarkers in medicine. 2017;11(7):535-40.
- 18. Yu W, Dou Y, Wang K, Liu Y, Sun J, Gao H, et al. Preoperative neutrophil lymphocyte ratio but not platelet lymphocyte ratio predicts survival and early relapse in patients with oral, pharyngeal, and lip cancer. Head & neck. 2019.
- 19. Westerdijk K, Simons KS, Zegers M, Wever PC, Pickkers P, de Jager CP. The value of the neutrophil-lymphocyte count ratio in the diagnosis of sepsis in patients admitted to the Intensive Care Unit: A retrospective cohort study. PloS one. 2019;14(2):e0212861.
- 20. Yavuzcan A, Caglar M, Ustun Y, Dilbaz S, Yidiz E, Ozbilgec S, et al. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekologia polska. 2014;85(3).
- 21. Gogoi P, Sinha P, Gupta B, Firmal P, Rajaram S. Neutrophil‐to‐lymphocyte ratio and platelet indices in pre‐eclampsia. International Journal of Gynecology & Obstetrics. 2019;144(1):16-20.
- 22. Toptas M, Asik H, Kalyoncuoglu M, Can E, Can MM. Are neutrophil/lymphocyte ratio and platelet/lymphocyte ratio predictors for severity of preeclampsia? Journal of Clinical Gynecology and Obstetrics. 2016;5(1):27-31.
- 23. Serin S, Avcı F, Ercan O, Köstü B, Bakacak M, Kıran H. Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2016;6(1):22-5.
- 24. Abd-Alazim M, Mohammad AH, Radwan MS, Shokr AA. Is Neutrophil/Lymphocyte Ratio A Useful Marker to Predict the Severity of Pre-Eclampsia? Egyptian Journal of Hospital Medicine. 2018;73(5).
- 25. Kholief A, Swilam R, Elhabashy A, Elsherief R. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and c-reactive protein as markers for severity of pre-eclampsia. Research and Opinion in Anesthesia and Intensive Care. 2019;6(1):1.
- 26. Sacks GP, Studena K, Sargent IL, Redman CW. Normal pregnancy and preeclampsia both produce inflammatory changes in peripheral blood leukocytes akin to those of sepsis. American journal of obstetrics and gynecology. 1998;179(1):80-6.
- 27. Steinberg G, Khankin EV, Karumanchi SA. Angiogenic factors and preeclampsia. Thrombosis Research. 2009;123:S93-S9.
- 28. Redman C, Sargent I. Placental debris, oxidative stress and pre-eclampsia. Placenta. 2000;21(7).
- 29. Wang J, Zhu Q-W, Cheng X-Y, Liu J-y, Zhang L-l, Tao Y-M, et al. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. Journal of reproductive immunology. 2019;132:29-34.