Akut Koroner Sendromlu Hastalarda Nötrofil/Lenfosit Oranı ve Monosit Sayımının Değerlendirilmesi

Öz

Amaç: Akut koroner sendromlar, dünyada ve ülkemizde tüm ölüm sebepleri içerisinde en üst sırada yer almaktadır. Bu çalışmada tam kan sayımı parametrelerinin akut koroner sendromların klinik seyrinde prediktif açıdan değerli olup olmadığını araştırmak amaçlanmıştır.
Materyal ve Metot: Çalışma, yıllık hasta sayısı 150.000 olan bir Eğitim ve Araştırma Hastanesi Acil Tıp Kliniği’nde 01.02.2017-31.07.2017 tarihleri arasında tek merkezli prospektif olarak gerçekleştirildi. Çalışma için Lokal Klinik Araştırmalar Etik Kurulu’ndan etik onayı alındı. Hastaların demografik özellikleri, tam kan parametreleri, nötrofil / lenfosit oranı (NLR), GRACE risk skorları kayıt altına alındı. Hastaların hastanede kalış süreleri, hastane içi mortaliteleri ve 6 aylık mortaliteleri takip edildi.
Bulgular: Çalışmadaki hastaların %77,27’ ü erkek, %22,73’ si kadındı. Yaş ortalaması 61±12 idi. Tüm gruplar içerisinde NLR değerleri (p=0,009), monosit sayıları (p<0,001) arasında hastane içi mortalite açısından anlamlı fark saptandı. NLR değerleri (p=0,045), monosit sayıları (p=0,026) arasında da 6 aylık mortalite açısından anlamlı fark saptandı. Hastane içi mortalite açısından NLR düzeyi düşük grup ile diğer gruplar arasında anlamlı fark saptanmıştır (p=0,006), Bu çalışmada NLR alt grupları arasında 6 aylık mortalite açısından anlamlı fark saptanmamıştır (p=0,131). GRACE skoru ve NLR arasında zayıf (p<0,001; rho=0,393) korelasyon saptandı.
Sonuç: Akut koroner sendrom nedeniyle acil servislerde takip edilen hastalarda tam kan parametreleri ve NLR gibi parametreler klinik karar verme sürecinde ve hastaların prognozunu ve mortalitelerini öngörmede yardımcı olabilir.

Anahtar Kelimeler

• Akut koroner sendrom,nötrofil,lenfosit,monosit,nötrofil/lenfosit oranı

The Evaluation of Neutrophil/Lymphocyte Rates and Monocyte Counts in Patients with Acute Coronary Syndrome

Abstract

Objectives: Acute coronary syndromes are at the top of all causes of death in the world and in our country. In this study, we aimed to evaluate whether total blood count parameters have predictive value in clinical course of acute coronary syndromes.
Materials and Methods: The study was performed as a single center prospective study between 01.02.2017 and 31.07.2017 at the Emergency Medicine Clinic of a Training and Research Hospital in which the annual number of patients is 150,000. Ethics approval was obtained from the Local Clinical Research Ethics Committee for the study. Demographic feature, total blood count parameter, neutrophil / lymphocyte ratio (NLR), GRACE risk score of the patients were recorded. Length of stay, in-hospital mortality and 6-month mortality of the patients were followed.
Results: In this study, 77.27% of the patients were male and 22.73% were female. The mean age was 61 ± 12. There were significant differences between NLR’s (p = 0.009) and monocyte counts (p <0.001) in all groups in terms of in-hospital mortality. There were also significant differences between NLR’s (p = 0,045) and monocyte counts (p = 0,026) in terms of 6-month mortality. There was a significant difference between the group with low NLR and the other groups in terms of hospital mortality (p = 0,006). There was no significant difference between NLR subgroups in terms of 6-month mortality in this study (p = 0.131). There was a weak correlation between GRACE score and NLR (p <0.001; rho = 0.393).
Conclusion: Parameters such as total blood count and NLR in patients followed up in emergency departments due to acute coronary syndrome may help in the clinical decision making process and predicting the prognosis and mortality of patients.

Keywords

• Acute coronary syndrome,neutrophil,lymphocyte,monocyte,neutrophil / lymphocyte ratio

Kaynakça

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