Araştırma Makalesi
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Akut Kolesistit Tanısında Kan Parametreleri ve Türevlerinin Tanı Koymadaki Etkinliği

Yıl 2020, Cilt: 7 Sayı: 3, 135 - 140, 29.12.2020

Levent Şahin , Hüseyin Fatih Gül , Turgut Dolanbay , Mustafa Makav , Murat Aras

https://doi.org/10.47572/muskutd.727620
Cited By: 1

Öz

Çalışmadaki amaçlarımız, akut kolesistitli hastaların demografik verilerini değerlendirmek ve nötrofil lenfosit oranı (NEU/LYM) başta olmak üzere çeşitli enfeksiyon parametreleri ve oranlarının tanı koymadaki sensitiviteleri ile spesifitelerini belirlemektir. Karın ağrısı şikayeti ile acil servise başvuran akut kolesistit tanısı konulan (kolesistit grubu) 59 hasta ile akut kolesistit tanısı almayan karın ağrısı şikayeti ile gelen (kontrol grubu) 66 hasta incelendi. Hastaların yaş, cinsiyet, başvuru anındaki şikayetleri gibi demografik verileri ve laboratuvar parametreleri çalışma formlarına kayıt edildi ve istatistiksel analizleri yapıldı. Kolesistit grubunda 22 (%37.3) kadın hasta, 37 (%62.7) erkek hasta vardı. Yaş dağılımına bakıldığında bakıldığında toplam hasta grubunun %30.5’i 65 yaş üstü hastalardı. Başvuru şikayetlerine göre değerlendirildiğinde en sık karın ağrısı (%92.2) şikayeti vardı. Kontrol grubunda white blood cell (WBC), NEU, c-reaktif protein (CRP), NEU/LYM, WBC/mean platelet volume (MPV) oranı ve CRP/LYM oranı değerlerindeki artış ve WBC/NEU değerindeki düşüş istatistik açıdan anlamlı bulundu (p<0.05). Kolesistit grubunun, kontrol grubuyla karşılaştırılması sonucu ROC analizi yapılmış ve cut off değerleri; WBC: 7.25 103/µl, lenfosit: 2.07 103 cells/uL, nötrofil: 4.5 103/µl, CRP: 0.17 mg/L, WBC/NEU: 1.62, NEU/LYM: 2.06, WBC/MPV: 0.873 ve CRP/LYM: 0.06 olarak tespit edilmiştir. Akut kolesistitte WBC, nötrofil, CRP, NEU / LYM, WBC / MPV ve CRP / LYM oranlarının klinik kullanımda tanı açısından faydalı olabileceğini düşünüyoruz.

Anahtar Kelimeler

Acil C-reaktif Protein Kolesistit Nötrofil Lenfosit Oranı

Kaynakça

  • 1. Fialkowski E, Halpin V, Whinney RR. Acute cholecystitis. BMJ Clin Evid. 2008. 2008;12:0411.
  • 2. Aufderheide TJ, Brady WJ, Tintinalli JE. Cholecystitis and Biliary Colic. In: Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine, A Comprehensive Study Guide. 5th ed. 2000:576-580. USA: McGraw-Hill.
  • 3. Chen CL, Shapiro ML, Angood PB, Makary MA. Patient Safety. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE, eds. Schwartz’s Principles of Surgery. 9th ed. 2009. New York: McGraw-Hill.
  • 4. Yusoff IF, Barkun JS, Barkun AN. Diagnosis and management of cholecystitis and cholangitis. Gastroenterol Clin N Am. 2003;32(4):1145-68.
  • 5. Hwang H, Marsh I, Doyle J. Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital. Can J Surg. 2014;57(3):162-8.
  • 6. Sayit AT, Gunbey PH, Terzi Y. Is the mean platelet volume in patients with acute cholecystitis an inflammatory marker?. J Clin Diagn Res.2015;9(6),TC05.
  • 7. Chen Q, Yang LX, Li XD, et al. The elevated preoperative neutrophil to lymphocyte ratio predicts poor prognosis in intrahepatic cholangiocarcinoma patients undergoing hepatectomy. Tumour Biol. 2015;36(7):5283-9.
  • 8. Prajapati JH, Sahoo S, Nikam T, Shah KH, Maheriya B, Parmar M. Association of high density lipoprotein with platelet to lymphocyte and neutrophil to lymphocyte ratios in coronary artery disease patients. J Lipids. 2014. 2014:686791.
  • 9. Yeniocak S, Turkmen S, Uzun O, et al. Akut karın ağrısıyla acil servise başvuran hastaların analizi. JAEM. 2012;11:212-5.
  • 10. Bedel C. Can we use neutrophil lymphocyte ratioand platelet lymphocyte ratioas a potential biomarker for acute cholecystitis?. Ortadogu Med J. 2019;11(4):404-8.
  • 11. Lee SK, Lee SC, Park JW, Kim SJ. The utility of the preoperative neutrophil to lymphocyte ratio in predicting severe cholecystitis: a retrospective cohort study. BMC Surg. 2014;14(1):100.
  • 12. Castro E, Lozano R, Olmos D. Neutrophil to lymphocyte ratio: another drop in the ocean of CRPC biomakers? Ann Oncol. 2015;26(4):622-3.
  • 13. Başol N, Çığşar G, Karaman S, Özsoy Z, Özdemir MB. Acil serviste akut kolesistit tanısı konulan hastaların NEU/LYM oranı ve epidemiyolojik açıdan değerlendirilmesi: Üç yıllık analiz. FNG & Bilim Tıp Derg. 2015;1(3):145-9.
  • 14. Beliaev AM, Angelo N, Booth M, Bergin C. Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis. J Surg Res. 2007;209:93-101.
  • 15. Doğan M. Acil Servise Başvurup Akut Kolesistit Tanısı Almış Hastaların Muayene ve Labaratuar Sonuçlarının Tanı Üzerindeki Değerlerinin Belirlenmesi. T.C. Sağlık Bilimleri Üniversitesi, Fatih Sultan Mehmet Sağlık Uygulama ve Araştırma Merkezi, Acil Tıp Kliniği. Tıpta Uzmanlık Tezi. İstanbul. 2017.
  • 16. Şakalar Ş. Blood Procalcitonin Level in Determining The Severity of Acute Cholecystitis in The Emergency Department. Eskişehir Osmangazi University Faculty of Medicine, Medical Speciality Thesis in Department of Emergency Medicine. Eskişehir. 2015.
  • 17. Cardall T, Glasser J, Guss DA. Clinical value of the total white blood cell count and temperature in the evaluation of patients with suspected appendicitis. Acad Emerg Med. 2004;11(10):1021-7.
  • 18. Ay S, Tanrıkulu CS. Diagnostic utility of neutrophil lymphocyte ratio in acute complicated cholecystitis. Ann Med Res. 2019;26(2):135-8.

The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis

Yıl 2020, Cilt: 7 Sayı: 3, 135 - 140, 29.12.2020

Levent Şahin , Hüseyin Fatih Gül , Turgut Dolanbay , Mustafa Makav , Murat Aras

https://doi.org/10.47572/muskutd.727620
Cited By: 1

Öz

The aims of our study are to evaluate the demographic data of patients admitted to the emergency room with acute cholecystitis and determine the sensitivity and specificity of various infection parameters and ratios, primarily the neutrophil lymphocyte ratio (NEU/LYM), in diagnosis. 59 patients diagnosed with acute cholecystitis (the cholecystitis group) and 66 patients not diagnosed with acute cholecystitis (the control group) were viewed. Both groups were admitted to the emergency room with abdominal pain. The demographic data of the patients such as age, gender, complaints during their admission, and their laboratory parameters were recorded on their forms and their statistical analyses were conducted. There were 22 (37.3%) female patients and 37 (62.7%) male patients in the cholecystitis group. Considering the age distribution, 30.5% of the total patient group was over the age of 65. When the admission complaints were evaluated, the most frequent complaint (92.2%) was abdominal pain. The increase in white blood cells (WBC), NEU, c-reactive proteins (CRP), NEU/LYM, WBC/mean platelet volume (MPV) levels and decrease in WBC/NEU levels in the control group were found to be statistically significant (p<0.05). As a result of comparing the cholecystitis group with the control group, a ROC analysis was conducted and the cut-off values were determined as; WBC: 7.25 103/µl, lymphocyte: 2.07 103 cells/uL, neutrophil: 4.5 103/µl, CRP: 0.17 mg/L, WBC/NEU: 1.62, NEU/LYM: 2.06, WBC/MPV: 0.873 and CRP/LYM: 0.06. We think that WBC, neutrophil, CRP, NEU/LYM, WBC/MPV and CRP/LYM ratios in acute cholecystitis, can be beneficial in clinical use in terms of the diagnosis.  

Anahtar Kelimeler

Cholecystitis C-reactive Protein Emergency Neutrophil Lymphocyte Ratio

Kaynakça

  • 1. Fialkowski E, Halpin V, Whinney RR. Acute cholecystitis. BMJ Clin Evid. 2008. 2008;12:0411.
  • 2. Aufderheide TJ, Brady WJ, Tintinalli JE. Cholecystitis and Biliary Colic. In: Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine, A Comprehensive Study Guide. 5th ed. 2000:576-580. USA: McGraw-Hill.
  • 3. Chen CL, Shapiro ML, Angood PB, Makary MA. Patient Safety. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE, eds. Schwartz’s Principles of Surgery. 9th ed. 2009. New York: McGraw-Hill.
  • 4. Yusoff IF, Barkun JS, Barkun AN. Diagnosis and management of cholecystitis and cholangitis. Gastroenterol Clin N Am. 2003;32(4):1145-68.
  • 5. Hwang H, Marsh I, Doyle J. Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital. Can J Surg. 2014;57(3):162-8.
  • 6. Sayit AT, Gunbey PH, Terzi Y. Is the mean platelet volume in patients with acute cholecystitis an inflammatory marker?. J Clin Diagn Res.2015;9(6),TC05.
  • 7. Chen Q, Yang LX, Li XD, et al. The elevated preoperative neutrophil to lymphocyte ratio predicts poor prognosis in intrahepatic cholangiocarcinoma patients undergoing hepatectomy. Tumour Biol. 2015;36(7):5283-9.
  • 8. Prajapati JH, Sahoo S, Nikam T, Shah KH, Maheriya B, Parmar M. Association of high density lipoprotein with platelet to lymphocyte and neutrophil to lymphocyte ratios in coronary artery disease patients. J Lipids. 2014. 2014:686791.
  • 9. Yeniocak S, Turkmen S, Uzun O, et al. Akut karın ağrısıyla acil servise başvuran hastaların analizi. JAEM. 2012;11:212-5.
  • 10. Bedel C. Can we use neutrophil lymphocyte ratioand platelet lymphocyte ratioas a potential biomarker for acute cholecystitis?. Ortadogu Med J. 2019;11(4):404-8.
  • 11. Lee SK, Lee SC, Park JW, Kim SJ. The utility of the preoperative neutrophil to lymphocyte ratio in predicting severe cholecystitis: a retrospective cohort study. BMC Surg. 2014;14(1):100.
  • 12. Castro E, Lozano R, Olmos D. Neutrophil to lymphocyte ratio: another drop in the ocean of CRPC biomakers? Ann Oncol. 2015;26(4):622-3.
  • 13. Başol N, Çığşar G, Karaman S, Özsoy Z, Özdemir MB. Acil serviste akut kolesistit tanısı konulan hastaların NEU/LYM oranı ve epidemiyolojik açıdan değerlendirilmesi: Üç yıllık analiz. FNG & Bilim Tıp Derg. 2015;1(3):145-9.
  • 14. Beliaev AM, Angelo N, Booth M, Bergin C. Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis. J Surg Res. 2007;209:93-101.
  • 15. Doğan M. Acil Servise Başvurup Akut Kolesistit Tanısı Almış Hastaların Muayene ve Labaratuar Sonuçlarının Tanı Üzerindeki Değerlerinin Belirlenmesi. T.C. Sağlık Bilimleri Üniversitesi, Fatih Sultan Mehmet Sağlık Uygulama ve Araştırma Merkezi, Acil Tıp Kliniği. Tıpta Uzmanlık Tezi. İstanbul. 2017.
  • 16. Şakalar Ş. Blood Procalcitonin Level in Determining The Severity of Acute Cholecystitis in The Emergency Department. Eskişehir Osmangazi University Faculty of Medicine, Medical Speciality Thesis in Department of Emergency Medicine. Eskişehir. 2015.
  • 17. Cardall T, Glasser J, Guss DA. Clinical value of the total white blood cell count and temperature in the evaluation of patients with suspected appendicitis. Acad Emerg Med. 2004;11(10):1021-7.
  • 18. Ay S, Tanrıkulu CS. Diagnostic utility of neutrophil lymphocyte ratio in acute complicated cholecystitis. Ann Med Res. 2019;26(2):135-8.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Levent Şahin 0000-0003-0193-4393

Hüseyin Fatih Gül 0000-0002-9828-1298

Turgut Dolanbay 0000-0002-4092-1192

Mustafa Makav 0000-0003-1879-8180

Murat Aras 0000-0002-4329-4147

Yayımlanma Tarihi 29 Aralık 2020
Gönderilme Tarihi 27 Nisan 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 7 Sayı: 3

Kaynak Göster

APA Şahin, L., Gül, H. F., Dolanbay, T., Makav, M., vd. (2020). The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 7(3), 135-140. https://doi.org/10.47572/muskutd.727620
AMA Şahin L, Gül HF, Dolanbay T, Makav M, Aras M. The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis. MMJ. Aralık 2020;7(3):135-140. doi:10.47572/muskutd.727620
Chicago Şahin, Levent, Hüseyin Fatih Gül, Turgut Dolanbay, Mustafa Makav, ve Murat Aras. “The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 7, sy. 3 (Aralık 2020): 135-40. https://doi.org/10.47572/muskutd.727620.
EndNote Şahin L, Gül HF, Dolanbay T, Makav M, Aras M (01 Aralık 2020) The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 7 3 135–140.
IEEE L. Şahin, H. F. Gül, T. Dolanbay, M. Makav, ve M. Aras, “The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis”, MMJ, c. 7, sy. 3, ss. 135–140, 2020, doi: 10.47572/muskutd.727620.
ISNAD Şahin, Levent vd. “The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 7/3 (Aralık 2020), 135-140. https://doi.org/10.47572/muskutd.727620.
JAMA Şahin L, Gül HF, Dolanbay T, Makav M, Aras M. The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis. MMJ. 2020;7:135–140.
MLA Şahin, Levent vd. “The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 7, sy. 3, 2020, ss. 135-40, doi:10.47572/muskutd.727620.
Vancouver Şahin L, Gül HF, Dolanbay T, Makav M, Aras M. The Efficacy of Blood Parameters and Its Derivatives in the Diagnosis of Acute Cholecystitis. MMJ. 2020;7(3):135-40.

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