Hematolojik Parametreler Akut Pankreatitin Şiddetini Öngörebiliyor mu?

Abstract

Amaç: Nötrofil-lenfosit oranı (NLO), trombosit-lenfosit oranı (TLO), ortalama trombosit hacmi (MPV) ve eritrosit dağılım genişliğinin (RDW) sistemik inflamasyon ile ilişkili olduğu kabul edilir. Bu çalışmada, akut pankreatitte (AP) prognostik faktörler olarak NLO, TLO, MPV ve RDW değerlerinin incelenmesi amaçlanmıştır.

Gereç ve Yöntemler: Mayıs 2016 ile Mayıs 2019 tarihleri arasında Sağlık Bilimleri Üniversitesi Gazi Yaşargil Eğitim ve Araştırma Hastanesine başvuran ve AP tanısı konulan toplam 315 hasta çalışmaya dahil edildi. Hasta verileri retrospektif olarak analiz edildi. Hastaların hastaneye başvuru zamanındaki laboratuvar değerleri kaydedildi ve Ranson skoru hesaplandı. Hastalar, Ranson skoru <3 (hafif AP) ve ≥3 (şiddetli AP) olanlar şeklinde iki gruba ayrıldı. Bu gruplar arasında NLO, TLO, MPV ve RDW parametreleri karşılaştırıldı.

Bulgular: Hastaların 103’ü (%32,7) erkek ve 212’si (%67,3) kadın olup yaş ortalaması 57,2±19,5 idi. Ranson kriterlerine göre skoru 3’ün altında olan hasta sayısı 274 (%87,0), skoru 3 ve üstünde olan hasta sayısı ise 41 (%13,0) olarak saptandı. Şiddetli AP grubunda NLO ve PLO, hafif AP grubuna göre anlamlı derecede yüksekti (sırasıyla 16,2±14,3'e karşı 8,2±7,7; p<0,001 ve 283,7±223,0 karşı 195,5±139,3; p=0,004), ancak RDW-CV ve MPV açısından istatistiksel olarak anlamlı bir farklılık yoktu (sırasıyla 13,7±1,0'e karşılık 13,9±1,9; p=0,849 ve 9,7±1,3'e karşı 9,5±1,1; p=0,201).

Sonuç: NLO ve PLO, AP şiddetini belirlemek için kullanabilecek olan basit ve güvenli testlerdir.

Keywords

• Akut Pankreatit şiddeti
• Ranson Kriterleri
• Nötrofil-Lenfosit Oranı
• Trombosit-Lenfosit Oranı
• Eritrosit dağılım genişliği
• Ortalama Trombosit Hacmi

Can Hematological Parameters Predict the Severity of Acute Pancreatitis?

Abstract

Aim: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV) and erythrocyte distribution width (RDW) are considered to be associated with systemic inflammation. In this study, it was aimed to evaluate NLR, PLR, MPV and RDW as prognostic factors in acute pancreatitis (AP).

Material and Methods: A total of 315 patients admitted to Health Sciences University Gazi Yaşargil Training and Research Hospital between May 2016 and May 2019 and diagnosed with AP were included in the study. Data of the patients were analyzed retrospectively. Laboratory values of the patients at the time of admission to the hospital were recorded and the Ranson score was calculated. Patients were divided into two groups as Ranson score <3 (mild AP) and ≥3 (severe AP). NLR, PLR, MPV and RDW parameters were compared between these groups.

Results: Of the patients, 103 (32.7%) were males and 212 (67.3%) were females, and mean age was 57.2±19.5. According to the Ranson criteria, number of patients with a score below 3 was 274 (87.0%), and number of patients with a score of 3 or above was 41 (13.0%). In the severe AP group, NLR and PLR were significantly higher than in the mild AP group (16.2±14.3 vs. 8.2±7.7, p<0.001 and 283.7±223.0 vs. 195.5±139.3, p=0.004 respectively), but there was no statistically significant difference in terms of RDW-CV and MPV (13.7±1.0 vs. 13.9±1.9, p=0.849 and 9.7±1.3 vs. 9.5±1.1, p=0.201, respectively).

Conclusion: NLR and PLR are simple and safe tests that can be used to determine the severity of AP.

Keywords

• Acute pancreatitis severity
• Ranson Criteria
• Neutrophil to lymphocyte ratio
• Platelet to lymphocyte ratio
• Erythrocyte distribution width
• Mean platelet volume

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