Acil Serviste Renal Koliği Olan Hastalarda Tiyol/Disülfid Homeostazı Nötrofil Lenfosit ve Platelet Lenfosit Oranı

Öz

Amaç: Bu çalışmanın amacı acil servise renal kolik nedeniyle başvuran hastalarda oksidatif stres

markerlarından olan tiyol/disülfid homeostazı parametreleri ile Nötrofil‐Lenfosit ve Platelet‐Lenfosit

oranlarının (NLO, PLO) beraber kullanımının tanı açısından yararlı olup olmadığını araştırmaktır.

Materyal ve Metot: Çalışma 15.05.2018 ile 01.10.2018 tarihleri arasında acil servise başvuran ve çalışmaya

alınan 75 hasta ve kontrol grubu olarak belirlenen 47 sağlıklı kişi ile prospektif olarak yapıldı. Erel ve

Neşelioğlu tarafından yeni geliştirilen bir metot ile oksidatif stres belirteci olan tiyol/disülfid homeostaz

parametreleri ( Tiyol, disülfid, disülfid / native tiyol, disüfid / total tiyol, native tiyol / total tiyol) ile NLO

ve PLO hasta ve kontrol grubunda çalışıldı. Üriner taş hastalığı olan ve olmayanlar arasında bu

parametreler karşılaştırıldı.

Bulgular: Renal koliği olanlarda kontrol grubuna göre, NLO, PLO, disülfid, disülfid /native tiyol ve

disülfid /total tiyol ortalama değerleri anlamlı derecede yüksek bulunurken (sırasıyla p= 0.010, <0.001,

<0.001, <0.001, 0.023, 0.012), native tiyol ve total tiyol ortalama değerleri anlamlı derecede düşük

bulundu (sırasıyla p=0.018 ve 0.001). Üriner taş hastalığı olan grupta olmayan gruba göre disülfid,

disülfid /native tiyol, NLO ve PLO ortalama değerleri anlamlı derecede yüksek bulundu (sırasıyla p

<0.001, <0.001, <0.001, <0.001).

Sonuç: NLO ve PLO ile tiyol/disülfid homeostaz parametrelerinin renal kolik tanısında beraber

kullanılması bu hastalarda tanının konulması açısından faydalıdır.

Anahtar Kelimeler

• Renal Kolik,oksidatif stres,tiyol/disülfid homeostazı

Thiol/Disulphide Homeostasis Neutrophil Lymphocyte and Platelet Lymphocyte Ratio in Emergency Department Patients with Renal Colic

Abstract

Objectives: This study's aim is to investigate if using thiol/disulphide homeostasis parameters which are oxidative stress markers together with Neutrophile-Lymphocyte and Platelet-Lymphocyte ratio (NLR, PLR) is diagnostically useful in the patients who present to the emergency department with renal colic.
Materials and Methods: The study was made prospectively with 75 patients who were admitted to the emergency department between 15.05.2018 and 01.10.2018 and 47 healthy subjects who were determined as control group. Thiol/disulphide homeostasis parameters (thiol, disulphide, disulphide / native thiol, disulphide / total thiol, native thiol / total thiol) which are oxidative stress markers are measured by a new method which was developed by Erel and Neşelioğlu in the patient and control groups, also NLR and PLR were studied. These parameters were compared also between the patient groups with urinary stone disease and that without.
Results: NLR, PLR, disulphide, disulphide /native thiol and disulphide /total thiol average values were found significantly high (respectively p= 0.010, <0.001, <0.001, <0.001, 0.023, 0.012), but native thiol and total thiol average values were found significantly low (respectively p=0.018 and 0.001) in the patient group. Disulphide, disulphide /native thiol, NLR and PLR average values were found significantly high (respectively p <0.001, <0.001, <0.001, <0.001) in the patient group.
Conclusion: Using NLR and PLR in renal colic diagnosis together with thiol/disulphide homeostasis parameters is useful for these patients to make a diagnosis.

Keywords

• Renal colic,oxidative stres,thiol/disulphide homeostasis

Kaynakça

1. 1. Duran L, Acar E, Çelenk Y et al. Evaluation of patients presenting with renal colic in emergency. Kocatepe Medical Journal 2014;15:274-8.
2. 2. Picozzi SC, Marenghi C, Casellato S et al. Managment of ureteral calculi and medical expulsive therapy in emergency departments. J Emerg Trauma Shock 2011;4:70-6.
3. 3. Bultitude M and Rees J. Managment of renal colic.BMJ 2012;345:e5499. doi:10.1136/bmj.e5499.
4. 4. Johri N, Cooper B, Robertson W et al. An update and practical guide to renal stone managment. Nephron Clin Pract 2010;116:159-71.
5. 5. Tadayyon F, Yzdani M, Ebadzadeh M. A comparison study between theophylline and placebo in passage of ureteral stones. Urol J 2004;1:204-7.
6. 6. Shihamura T. Mechanisms of renal tissue destruction in an experimental acute pyelonephritis. Exp Mol Pathol 1981;34:34-42.
7. 7. Monga M,Roberts JA. The possible role of granulocyte elastase in renal damage from acute pyelonephritis. Pediatr Nephrol 1995;9:583-6.
8. 8. Lowsby R, Gomes C,Jarman I et al. Neutrophile to lymphocyte count ratio as an early indicator of blood stream infection in the emergency department. Emerg Med J 2015;32:531-4.

9. 9. Bolat D, Topcu YF, Aydogdu O et al. Neutrophil to lymphocyte ratio as a predictor of early penile prosthesis implant infection. Int Urol Nephrol 2017;49:947-53.
10. 10. Acar E, Ozcan O, Deliktas H et al. Laboratory markers has many valuable parameters in discrimination between acute appendicitis and renal colic. Ulus Travma Acil Cerrahi Derg 2016;22(1):17-22.
11. 11. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014;47:326–32.
12. 12. Ellman G, Lysko H. A precise method for the determination of whole blood and plasma sulfhydryl groups. Anal Biochem 1979;93:98–102.
13. 13. Curhan GC. Epidemiology of stone disease. Urol Clin N Am 2007;34:287-93.
14. 14. Nuss GR, Rackey JD, Assimos DG. Adjunctive therapy to promote stone passage. Rev Urol 2005;7:67-74.
15. 15. Horton JW. Free radicals and lipid peroxidation mediated injury in burn trauma: The role of antioxidant therapy. Toxicology 2003;189(1-2):75-88.
16. 16. Kundi H, Erel Ö, Balun A, Çiçekçioglu H, Cetin M, Kiziltunç E et al. Association of thiol/disulfide ratio with syntax score in patients with NSTEMI. Scand Cardiovasc J 2015;49:95–100.
17. 17. Eren Y, Dirik E, Neselioglu S, Erel O. Oxidative stress and decreased thiol level in patients with migraine: cross-sectional study. Acta Neurol Belg 2015;115:643–9.
18. 18. Peng W, Li C, Wen TF et al. Neutrophile to lymphocyte ratio changes predict small hepatocelluler carcinoma survival. J Surg Res 2014;192:402-8.
19. 19. Bhar T, Teli S, Rijal J et al. Neutrophile to lymphocyte ratio and cardiovascular disease: a review. Expert Rev Cardiovasc Ther 2013;11:55-9.
20. 20. Sfoungaristos S, Kavouras A, Katafigiotis I, Perimenis P. Role of White blood cell and neutrophile counts in predicting spontaneous stone passage in patients with renal colic. BJU International 2012,110:339-45.
21. 21. Parlak ES, Alisik M, Hezer H et al. Evaluation of dynamic thiol/disulphide redox state in community-acquired pneumonia. Saudi Med J. 2018 May;39(5):495-9.
22. 22. Bozkurt A, Mertoglu C, Karabakan M et al. Does extracorporeal shockwave lithotripsy therapy affect thiol-disulfide homeostasis? Pak J Med Sci 2018;34(5):1070-5.