İkiz prematüre bebek olmak sistemik inflamatuvar indeksleri nasıl etkiler?

Yıl 2024, Cilt: 49 Sayı: 3, 646 - 654, 30.09.2024

Ufuk Çakır , Cüneyt Tayman

https://doi.org/10.17826/cumj.1460277

Öz

Amaç: Sistemik inflamatuar indeksler neonatoloji alanında hastalıklarda yeni tanımlanan parametrelerdir. Ancak ikiz prematürelerde sistemik inflamatuar indeks düzeylerinin değişip değişmediği bilinmemektedir.
Gereç ve Yöntem: Çalışmamıza gebelik yaşı <32 hafta olan prematüre bebekler dahil edildi. Tüm hastaların demografik özellikleri, morbidite, mortalite, lökosit, nötrofil, monosit, lenfosit, trombosit sayı verileri geriye dönük olarak kaydedildi. Nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR), monosit-lenfosit oranı (MLR), sistemik immün inflamasyon indeksi (SII), pan-immün-inflamasyon değeri (PIV) ve sistemik inflamasyon yanıt indeksi (SIRI) değerleri hesaplandı. İkiz ve tekil bebekler demografik özellikler, morbidite, mortalite, tam kan sayımı parametreleri ve sistemik inflamatuar indeksler açısından birbirleriyle karşılaştırıldı.
Bulgular: Çalışmaya 200'ü ikiz, 753'ü tekil prematüre olmak üzere toplam 953 bebek dahil edildi. İkiz grupta sezaryen doğum, solunum sıkıntısı sendromu ve intraventriküler kanama tekil gruba göre daha yüksek bulundu. İkiz grupta lökosit, nötrofil, monosit, lenfosit sayısı daha düşük, trombosit sayısı ise tekil grupta anlamlı olarak yüksek bulundu. İkiz grupta tekil gruba göre PLR değeri (sırasıyla, 41,81 ve 32,09) daha yüksek, PIV değeri (sırasıyla, 43,66 ve 47,93) daha düşüktü. NLR, MLR, SII, SIRI değerleri ikiz ve tekil gruplar arasında benzerdi. Birinci ve ikinci ikiz prematüre bebeklerin demografik özellikleri, morbidite, mortalite, tam kan sayımı parametreleri ve sistemik inflamatuar indeksleri açısından farklılık yoktu.
Sonuç: İkizler ve tekiz prematüre bebekler arasındaki sistemik inflamatuar indeksler ve çoklu hematolojik parametrelerdeki farklılıklar klinik sonuçları anlamak için pre/postnatal koşullar değerlendirilerek dikkatle yorumlanmalıdır.

Anahtar Kelimeler

Sistemik inflamatuar indeksler, Yenidoğan, Prematüre, Tekil, İkiz

Etik Beyan

Çalışmaya başlamadan önce yerel etik kuruldan etik onay alındı.

Destekleyen Kurum

yok

Teşekkür

yok

How does being a twin premature infant affect systemic inflammatory indices?

Öz

Purpose: Systemic inflammatory indices are newly defined parameters in diseases in the field of neonatology. However, it is not known whether the levels of systemic inflammatory indices change in twin preterms.
Materials and Methods: Premature infants <32 weeks of gestational age were included in our study. Demographic characteristics, morbidity, mortality, leukocyte, neutrophil, monocyte, lymphocyte, platelet count data of all patients were recorded retrospectively. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune ratio-inflammation index (SII), pan-immune-inflammation value (PIV) and systemic inflammation response index (SIRI) values were calculated. Twins and singleton infants were compared with each other in terms of demographic characteristics, morbidity, mortality, complete blood count parameters and systemic inflammatory indices.
Results: A total of 953 infants, including 200 twins and 753 singleton premature infants, were included in the study. Cesarean section, respiratory distress syndrome, and intraventricular hemorrhage were found to be higher in the twins group compared to the singleton group. The leukocyte, neutrophil, monocyte, lymphocyte count was found to be lower in the twins group and the platelet count was found to be significantly higher in the singleton group. PLR value was higher (41.81 and 32.09, respectively) and PIV value was lower (43.66 and 47.93, respectively) in the twins group compared to the singleton group. NLR, MLR, SII, SIRI values were similar between twins and singleton groups. There was no difference in demographic characteristics, morbidity, mortality, complete blood count parameters and systemic inflammatory indices of the first and the second twin premature infants.
Conclusion: Differences in systemic inflammatory indices and multiple hematological parameters between twins and singleton premature infants should be interpreted carefully taking into account pre/postnatal conditions to understand clinical outcomes.

Anahtar Kelimeler

Systemic inflammatory indices, Infant, Premature, Singleton, Twin

Kaynakça

• Yildiz D, Cakir U, Tugcu AU, Tayman C. İkizlerde ikinci bebek olmak prematüre morbidite ve mortalitesini nasil etkiler?? The Journal of Kırıkkale University Faculty of Medicine. 2022;24:325-30.
• Shah J, Shah PS, Jefferies A. Hematological parameters immediately after birth in twins and higher order multiples. Am J Perinatol. 2015;32:653-8.
• Verbeek L, Slaghekke F, Sueters M, Middeldorp JM, Klumper FJ, Haak MC et al. Hematological disorders at birth in complicated monochorionic twins. Expert Rev Hematol. 2017;10:525-32.
• Cakir E, Ozkocak Turan I. Which hemogram-derived indices might be useful in predicting the clinical outcomes of sepsis patients in the intensive care unit? Cukurova Medical Journal. 2021;46:532-9.
• Russell CD, Parajuli A, Gale HJ, Bulteel NS, Schuetz P, de Jager CPC et al. The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis. J Infect. 2019;78:339-48.
• Ceran B, Alyamaç Dizdar E, Beşer E, Karaçağlar NB, Sarı FN. Diagnostic role of systemic inflammatory indices in infants with moderate-to-severe hypoxic ischemic encephalopathy. Am J Perinatol. 2024;41:248-54.
• Can E, Hamilcikan Ş, Can C. The value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for detecting early-onset neonatal sepsis. J Pediatr Hematol Oncol. 2018;40:e229-e232.
• Hu YX, Xu XX, Shao Y, Yuan GL, Mei F, Zhou Q, et al. The prognostic value of lymphocyte-to-monocyte ratio in retinopathy of prematurity. Int J Ophthalmol. 2017;10:1716-21.
• Stein AA, Eyerly-Webb S, Solomon R, Tani C, Shachar E, Kimball R et al. Peripheral blood neutrophil-to-lymphocyte ratio in preterm infants with intraventricular hemorrhage. Clin Neurol Neurosurg. 2019;180:52-6.
• Cakir U, Tayman C, Buyuktiryaki M. An unknown risk factor for sepsis in very low birth weight preterms: ABO Blood Groups (BGaPS Study). Am J Perinatol. 2021;38:669-75.
• Özkan H, Erdeve Ö, Kutman HGK. Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment. Turk Pediatri Ars. 2018;53:45-54.
• Cakir U, Tayman C. What should be the first-line treatment for the closure of hemodynamically significant patent ductus arteriosus in premature infants? Arq Bras Cardiol. 2022;118:548-55.
• Cakir U, Tayman C, Yarci E, Halil H, Buyuktiryaki M, Ulu HO et al. Novel useful markers for follow-up of necrotizing enterocolitis: endocan and interleukin-33. J Matern Fetal Neonatal Med. 2020;33:2333-41.
• Tayman C, Cakir U, Yucel C, Bekmez BO. Is endocan a novel diagnostic marker for the severity of bronchopulmonary dysplasia in very low birth weight infants? Arch Bronconeumol (Engl Ed). 2019;55:465-71.
• Chiang MF, Quinn GE, Fielder AR, Ostmo SR, Paul Chan RV, Berrocal A et al. International Classification of Retinopathy of Prematurity, Third Edition. Ophthalmology 2021;128:e51-e68.
• Volpe JJ. Impaired neurodevelopmental outcome after mild germinal matrix-intraventricular hemorrhage. Pediatrics. 2015;136:1185-7.
• Santarosa BP, Dantas GN, Ferreira DOL, Hooper HB, Porto ACRC, Garcia SMFC et al. Comparison of hematological parameters between single and twin pregnancies in Dorper ewes during gestation, lambing, and postpartum. Ciência Rural. 2022;52: e20201065.
• Sabre A, Sisti G, Gaither K. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in twins compared with singletons. South Med J. 2021;114:28-31.
• Rolim ACB, Lambert MA, Borges JPG, Abbas SA, Bordin JO, Langhi Junior DM, et al. Blood cells profile in umbilical cord of late preterm and term newborns. Rev Paul Pediatr. 2019;37:264-74.
• Christensen RD, Jensen J, Maheshwari A, Henry E. Reference ranges for blood concentrations of eosinophils and monocytes during the neonatal period defined from over 63 000 records in a multihospital health-care system. J Perinatol. 2010;30:540-5.
• Lee HR, Shin S, Yoon JH, Kim BJ, Hwang KR, Kim JJ, Roh EY. Complete blood count reference values of donated cord blood from Korean neonates. Korean J Lab Med. 2009;29:179-84.
• Christensen RD, Henry E, Jopling J, Wiedmeier SE. The CBC: reference ranges for neonates. Semin Perinatol. 2009;33:3-11.
• Jung E, Romero R, Yeo L, Diaz-Primera R, Marin-Concha J, Para R et al. The fetal inflammatory response syndrome: the origins of a concept, pathophysiology, diagnosis, and obstetrical implications. Semin Fetal Neonatal Med. 2020;25:101146.
• Visser GL, Tollenaar LSA, Bekker V, Te Pas AB, Lankester AC, Oepkes D et al. Leukocyte counts and other hematological values in twin-twin transfusion syndrome and twin anemia-polycythemia sequence. Fetal Diagn Ther. 2020;47:123-8.
• Sheffer-Mimouni G, Littner Y, Mimouni FB, Mandel D, Deutsch V, Dollberg S. Nucleated red blood cells in concordant, appropriate-for-gestational age twins. Am J Obstet Gynecol. 2004;191:1291-5.
• Nóbrega Lima Rodrigues de Morais A, Ribeiro Baylão VM, Martins Silva T, Gomes Dos Santos A, Azevedo M, J M de Oliveira A. Is neutrophil-lymphocyte ratio a useful tool for predicting outcome in subarachnoid hemorrhage? A systematic review. Neurosurg Rev. 2021;44:3023-8.
• Xia LJ, Li W, Zhai JC, Yan CW, Chen JB, Yang H. Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and prognostic nutritional index for predicting clinical outcomes in T1-2 rectal cancer. BMC Cancer. 2020;20:208.
• Ösken A, Çam N. The predictive value of systemic immune inflammation index on long-term mortality among patients with acute pulmonary embolism. J Health Sci Med. 2021;4: 557-63.
• Urbanowicz T, Michalak M, Olasińska-Wiśniewska A, Rodzki M, Witkowska A, Gąsecka A et al. Neutrophil counts, neutrophil-to-lymphocyte ratio, and systemic inflammatory response index (SIRI) predict mortality after off-pump coronary artery bypass surgery. Cells. 2022;11:1124.
• Zinellu A, Collu C, Nasser M, Paliogiannis P, Mellino S, Zinellu E et al. The aggregate index of systemic inflammation (AISI): A novel prognostic biomarker in idiopathic pulmonary fibrosis. J Clin Med. 2021;10:4134.
• Karabulut B, Arcagök BC, Simsek A. Utility of the platelet-to-lymphocyte ratio in diagnosing and predicting treatment success in preterm neonates with patent ductus arteriosus. Fetal Pediatr Pathol. 2021;40:103-12.
• Yang Y, Cao ZL, Zhou XY, Chen XQ, Pan JJ, Cheng R. Does neutrophil/lymphocyte ratio have good diagnostic value in neonatal necrotizing colitis? J Matern Fetal Neonatal Med. 2019;32:3026-33.
• Cakir U, Tayman C, Tugcu AU, Yildiz D. Role of systemic inflammatory indices in the prediction of moderate to severe bronchopulmonary dysplasia in preterm infants. Arch Bronconeumol. 2023;59:216-22.
• Cakir U, Tugcu AU, Tayman C, Yildiz D. Evaluation of the effectiveness of systemic inflammatory indices in the diagnosis of respiratory distress syndrome in preterm with gestational age of ≤32 weeks. Am J Perinatol. 2024;41(S 01):e1546-52.