Yenidoğanlarda sepsis ajanlarının erken saptanmasında trombosit indekslerinin rolü

Yıl 2024, Cilt: 49 Sayı: 3, 807 - 817, 30.09.2024

Adnan Barutçu , Ferda Özlü , Hacer Yapıcıoğlu , İlker Ünal

https://doi.org/10.17826/cumj.1503225

Öz

Amaç: Yenidoğan sepsisi, morbidite ve mortalitenin önemli bir nedenidir. Yenidoğan sepsisinin belirtileri ve semptomları spesifik olmayıp, tanı için ideal bir belirteç bulunmamaktadır. Çalışmamız, sepsis ajanlarını belirlemede trombosit indekslerinin rolünü araştırmayı amaçlamaktadır.
Gereç ve Yöntem: Sepsis tanısı olan toplam 90 hastanın kaydı retrospektif olarak incelenerek gram-pozitif, gram- negative ve Candida enfeksiyonu olan hastaların demografik ve klinik özellikleri karşılaştırıldı ve hastaların tanı anındaki ve enfeksiyonun beşinci günündeki tam kan sayımları değerlendirilerek, platelet sayıları (PLT), ortalama platelet hacmi (MPV), plateletkrit (PCT) ve dağılım genişliği (PDW) değerleri ROC eğrisi analizi ile karşılaştırıldı.
Bulgular: Cinsiyet, gestasyonel hafta, doğum ağırlığı, surfaktan kullanımı, mekanik ventilatör tedavisi gereksinimi ve nekrotizan enterokolit açısından gruplar arasında istatistiksel fark bulunamadı. İlk tespit edildiğinde, gram-pozitif bakteriyel enfeksiyonları tespit etmede PCT, PLT ve MPV (trombositopenisiz) değerlerinin ROC eğri-altı alan (AUC)'si sırasıyla 0,764, 0,765 ve 0,792 olarak bulundu.
Sonuç: İlk tanı anında PCT ve PLT değerlerindeki artış, gram-pozitif bakteriyel enfeksiyonları tanımak için kullanılabilir. MPV'de azalma ise trombositopeni görülmeyen mantar enfeksiyonları için erken tanı amaçlı kullanılabilir.

Anahtar Kelimeler

Yenidoğan, sepsis, ortalama platelet hacmi (MPV), plateletkrit (PCT), platelet (PLT)

The role of thrombocyte indices in early determination of sepsis agents in newborns

Öz

Purpose: Neonatal sepsis is an important cause of morbidity and mortality. The signs and symptoms of neonatal sepsis are nonspecific, and there is no ideal marker for diagnosis. Our study aimed to investigate the role of platelet indices in determining agents in sepsis.
Materials and Methods: A total of 90 records with sepsis data were examined retrospectively, demographic and clinical characteristics of gram-positive, gram-negative and Candida infection patients were evaluated by complete blood counts at the time of diagnosis and on the fifth day of infection and platelet amount (PLT), mean platelet volume (MPV), plateletcrit (PCT) and distribution width (PDW) values were compared by ROC curve analysis.
Results: No statistical difference was found between the groups in terms of gender, gestational week, birth weight, surfactant use, need for mechanical ventilator treatment, and necrotizing enterocolitis. When infection was first detected, the Area Under Curve (AUC) of PCT, PLT and MPV (without thrombocytopenia) values in detecting gram-positive bacterial infection were 0.764, 0.765 and 0.792 respectively.
Conclusion: The increase in PCT and PLT values at the time of initial diagnosis can be used to detect gram-positive bacterial infections. A decrease in MPV can be used for early diagnosis of fungal infections without thrombocytopenia.

Anahtar Kelimeler

Neonatal, Sepsis, Mean Platelet Volume (MPV), Plateletcrit(PCT), Platelet(PLT)

Kaynakça

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