Preeklampsi ve HELLP Sendromlu Olgularda Nötrofil-Lenfosit Oranı (NLO), Platelet-Lenfosit Oranı (PLO) ve Ortalama Platelet Hacminin (OPH) Karşılaştırılması

Öz

Amaç: Bu çalışmada hem HELLP sendromlu hem de preeklampsili hastaların NLO ve PLO değerleri normal sağlıklı kontrol grubu ile karşılaştırıldı. Metod: Bu çalışma, 2012-2020 yılları arasında Mersin Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum servisine yatan 50 HELLP sendromu, 110 şiddetli Preeklampsi (PE) ve 61 kontrol hastasının dosyaları taranarak retrospektif olarak yapıldı. Çalışmada HELLP sendromu ve preeklampsi hastaları, sağlıklı kontrol grubu ile karşılaştırıldı. Ek hastalığı olan hastalar çalışma dışı bırakıldı. Hasta gruplarının venöz kan hemogram parametreleri ve doğum sırasında alınan biyokimyasal değerleri kaydedildi. Hastaların yaşı, gebelik haftası, karaciğer fonksiyon testleri, böbrek fonksiyon testleri, hemogram parametreleri, NLO ve PLO değerleri ve oluşan komplikasyonlar karşılaştırıldı. Çalışmanın etik onamı alındı (Karar tarihi:28/04/2021; Karar sayısı: 343) Sonuçlar: Çalışmada nötrofil sayısı, HELLP sendromu grubunda, kontrol grubuna göre anlamlı olarak yüksek bulundu (sırası ile 9493 ve 7210 p=0,04). NLO, hem HELLP sendromu hem de PE grubunda, kontrol grubuna göre yüksek bulundu (HELLP sendromu grubunda kontrol grubuna göre anlamlı olarak yüksekti (sırası ile 5,47 ve 3,66, p=0,02)). PLO, hem HELLP sendromu hem de PE grubunda, kontrol grubuna göre düşük bulundu (HELLP sendromu grubunda, kontrol grubuna (sıra ile 72 ve 111,18, p=0,0001) ve PE grubuna göre (sırası ile 72 ve 107,75 p=0,0002) anlamlı olarak düşük bulundu). Platelet sayısında tüm gruplar arasında anlamlı fark vardı (HELLP sendromu grubunda, PE grubuna (sıra ile 139,181 ve 196,222, p=0,0002) ve kontrol grubuna (sıra ile 139,181 ve 222,639, p=0,0001) göre anlamlı olarak düşük bulundu. Ayrıca PE grubunda, kontrol grubuna göre (sırası ile 196,222 ve 222,639 p=0,003) anlamlı olarak düşük bulundu). OPH, HELLP sendromu grubunda kontrol grubuna göre (sıra ile 9,95 ve 11,13, p=0,04) anlamlı olarak düşük bulundu. Sonuç: Çalışmamızda inflamatuar belirteçlerden NLO’nun artışının ve PLO ve OPH’nin azalmasının hem HELLP sendromu tanısında hem de HELLP sendromu ile PE ayrımında kullanılabileceği sonucuna ulaşıldı

Anahtar Kelimeler

• HELLP sendromu
• Nötrofil-lenfosit oranı
• Ortalama platelet hacmi
• Preeklampsi
• Platelet-lenfosit oranı

Comparison of Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR) and Mean Platelet Volume (MPV) in cases with Preeclampsia and HELLP Syndrome

Öz

Objective: In this study, NLR and PLR values of both HELLP syndrome and preeclampsia patients were compared with normal healthy control group. Method: This study was performed retrospectively by scanning the files of 50 HELLP syndrome, 110 severe preeclampsia (PE) and 61 control patients admitted to the Mersin University Medical Faculty Obstetrics and Gynecology Unit between 2012-2020. In the study, patients with HELLP syndrome and preeclampsia were compared with a healthy control group. Patients with additional disease were excluded from the study. Venous blood hemogram parameters of the patient groups and biochemical values obtained during delivery were recorded. Patients' age, gestational week, liver function tests, kidney function tests, hemogram parameters, NLR and PLR values and complications were compared. Ethical consent of the study was obtained (Date of decision: 28/04/2021; Decision number: 343). Results: In the study, the neutrophil count was found to be significantly higher in the HELLP syndrome group compared to the control group (9493 and 7210, respectively, p=0.04). NLR was higher in both HELLP syndrome and PE groups compared to the control group (It was significantly higher in the HELLP syndrome group compared to the control group (5.47 and 3.66, respectively, p = 0.02)). PLR was found to be lower in both the HELLP syndrome and PE groups compared to the control group ((In the HELLP syndrome group, compared to control group (72 and 111.18, respectively, p = 0.0001) and PE group (72 and 107.75, respectively, p= 0.0002) was found to be significantly low)). There was a significant difference in the number of platelets between all groups (in the HELLP syndrome group, it was found to be significantly lower than the PE group (139.181 and 196.222, respectively, p = 0.0002) and the control group (139.181 and 222.639, respectively, p = 0.0001). In addition, it was found to be significantly lower in the PE group compared to the control group (196.222 and 222.639, respectively, p = 0.003). MPV was found to be significantly lower in the HELLP syndrome group compared to the control group (9.95 and 11.13, respectively, p = 0.04). Conclusion: In our study, it was concluded that the increase in NLR and the decrease in PLR and MPV, which are inflammatory markers, can be used both in the diagnosis of HELLP syndrome and in the differentiation of HELLP syndrome and PE. Keywords: HELLP syndrome, Neutrophil- lymphocyte ratio, Mean platelet volume, Preeclampsia, Platelet-lymphocyte ratio.

Anahtar Kelimeler

• Comparison of Neutrophil to Lymphocyte Ratio (NLR)
• Platelet to Lymphocyte Ratio (PLR) and Mean Platelet Volume (MPV) in cases with Preeclampsia and HELLP Syndrome
• Comparison of Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR) and Mean Platelet Volume (MPV) in cases with Preeclampsia and HELLP Syndrome

Kaynakça

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