Akut bakteriyel menenjitli hastalarda serum ve beyin omurilik sıvısındaki nöron spesifik enolaz düzeylerinin komplikasyonlar ve klinik takip ile ilişkisi

Öz

Amaç: Bu çalışmadaki amacımız; bakteriyel menenjitli hastalarda serum CRP ile BOS ve kan Nöron spesifik enolaz (NSE) düzeylerinin ilişkisini araştırmaktır Gereç ve Yöntemler: Bu çalışma Eylül 2000 ile Eylül 2001 tarihleri arasında akut bakteriyel menenjit tanısı konarak tedavi edilen 22 hastada gerçekleştirildi. Menenjit tanısı, öykü, klinik ve BOS bulguları ile konuldu. Hastalara başlangıç, 1. ve 7. günlerde ve düzelme olup olmamasına göre 15 ve 21. günlerde lomber ponksiyon (LP) yapıldı. Alınan BOS örneklerinden hücre sayımı, kültür, Wright ve Giemsa boyaması, protein, şeker ve NSE düzeyleri çalışıldı. Belirtilen dönemlerde tüm hastalara klinik skorlama yapıldı. Bulgular: Tedavi ile hastaların 1. ve 7. gün BOS protein düzeyleri ve lökosit sayısının anlamlı düşüş gösterdiği, klinik skor ve glukoz düzeyinin yükseldiği gözlendi (p<0.05). Başlangıç ve 1. gün bakılan BOS NSE düzeyleri ile serum CRP değerleri arasında pozitif korelasyon görülürken, serum NSE ile CRP ve BOS NSE düzeyleri arasında korelasyon saptanmadı. Komplikasyonu gelişen 4 hastanın glukoz, CRP ve BOS NSE değerlerinin diğer hastalara göre daha düşük, protein ve lökosit sayısının daha yüksek olduğu saptandı. Serum NSE değerleri arasında anlamlı bir fark bulunamadı (p>0.05). Sonuç: BOS ve serum NSE düzeyleri bakteriyel menenjit1i hastalarda nöronal hasarla birlikte değişmektedir ancak tedavi süresinin uzunluğu ve komplikasyon gelişimi ile NSE düzeyleri arasında bir ilişki saptanamamıştır.

Anahtar Kelimeler

• Akut bakteriyel menenjit
• Çocuk
• Nöron spesifik enolaz

RELATIONSHIP OF NEURON SPECIFIC ENOLASE LEVELS IN SERUM AND CEREBRO SPINAL FLUID WITH COMPLICATIONS AND CLINICAL FOLLOW-UP IN PATIENTS WITH ACUTE BACTERIAL MENINGITIS

Öz

Objective: Our aim in this study is to investigate the relationship between serum CRP levels and cerebrospinal fluid and blood Neuron-specific enolase (NSE) levels in patients with bacterial meningitis. Materials and Methods: This study was conducted on 22 patients treated with a diagnosis of acute bacterial meningitis. The diagnosis of meningitis was made based on patient history, clinical and laboratory findings. Lumbar puncture was performed on patients at the initial presentation, on days 1 and 7, and on days 15 and 21 if recovery was not observed. The collected samples were analyzed for cell count, culture, Wright and Giemsa staining, protein, and glucose levels. Clinical scoring was performed for all patients at the specified time points. Findings: With treatment, a significant decrease in cerebrospinal fluid protein levels and leukocyte count was observed on days 1 and 7, while clinical scores and glucose levels showed an increase (p<0.05). A positive correlation was observed between cerebrospinal fluid NSE levels and serum CRP values measured at baseline and day 1. However, no correlation was found between serum NSE and CRP or cerebrospinal fluid NSE levels. Four patients developed complication had lower glucose, CRP, and cerebrospinal fluid NSE levels but higher protein and leukocyte counts compared to the other patients. No significant difference was found in serum NSE levels (p>0.05). Conclusion: Cerebrospinal fluid and serum NSE levels change with neuronal damage in patients with bacterial meningitis, but no relationship was found between NSE levels and duration of treatment and development of complications.

Anahtar Kelimeler

• Acute bacterial meningitis
• Child
• Neuron-specific enolase

Kaynakça

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