Toplumdan Kazanılmış Pnömoni Hastalarında Prokalsitonin, C-Reaktif Protein, Kan Beyaz Küre Sayılarının ve Hemogram Alt Parametrelerinin Karşılaştırılması

Abstract

Amaç: Pnömoni, akciğerlerin klinik ve radyolojik olarak tespit edilen inflamasyonudur. Pnömoni hastalarının büyük kısmını toplumdan kazanılmış pnömoni (CAP) vakaları oluşturur. Tanıyı desteklemekte ve tedavinin takibinde hemogram ve C-reaktif proteinin (CRP) kullanımı yaygındır. Prokalsitonin, daha az erişilebilir ve pahalıdır. Ve hemogram alt parametrelerinin kullanımı pek yaygın değildir. Bu çalışmanın amacı, pnömonisi olan olgularda prokalsitonin, CRP, Beyaz Küre sayısı (WBC) ve hemogram alt parametreleri arasındaki ilişkiyi ve ayırıcı tanıda yeni hematolojik oranların etkinliğini araştırmaktır. Gereç ve Yöntem: Hastanemiz göğüs hastalıkları polikliniğine başvurarak toplumdan kazanılmış pnömoni tanısı alan olgular retrospektif olarak incelendi. Kadın-erkek fark etmeden klinik ve radyolojik olarak olarak tanı almış 67 hasta çalışmamıza dahil edildi. Olguların anamnez bilgileri ve ek hastalıkları sorgulandı. Hastaların prokalsitonin, CRP ve hemogram (nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR) ve monosit-lenfosit oranı (MLR) hesaplandı ve WBC değerine bakıldı) kaydedildi. Elde edilen veriler istatistik olarak değerlendirildi ve değişkenler açısından karşılaştırıldı. Bulgular: Hastalarımızın yaş ortalaması 57 (18-71)’idi. 41 (%61,19) kadın ve 26 (%38,81) erkek hasta vardı. Hastalarımızın 36 (%53,73) tanesinin kronik hastalıkları mevcuttu; 21 (%31,34) tanesinde kalp hastalığı, 23 (%34,32) tanesinde diabet, 6 (%8,95) tanesinde böbrek yetmezliği vardı. Hastalarda; 48 (%71,64) prokalsitonin, 56 (%83,58) CRP, 38 (%56,71) WBC, 52 (%77,61) NLR, 34 (%50,74) PLR ve 38 (%56,71) MLR değerleri yüksekti. Prokalsitonin, CRP ve NLR değerleri diğer alt parametrelerinden daha anlamlı yüksekti. Ek bir kronik hastalığı olan hastaların CRP ve NLR değerleri ek hastalığı olmayan hastalardan daha yüksekti. Korelasyon analizlerinde prokalsitonin, CRP ve NRL arasında güçlü korelasyon vardı, diğerleri arasındaki korelasyon anlamlı değildi. (p <0.001). Sonuç: Çalışmamız CAP hastalarında hemogram alt parametrelerinden NLR’nin güvenle kullanılabileceğini göstermektedir. Prokalsitoninin pahalı bir testtir. Birinci basamak aile sağlığı merkezlerinde Prokalsitoninin bulunmadığı ve CRP’nin bazı aile sağlığı merkezlerinde bulunduğu düşünüldüğünde NLR’nin hesaplanarak kullanılmasının tanıyı destekleyeceğini göstermiştir. İkinci ve üçüncü basamak sağlık tesislerinde de daha az tetkik kullanmak sağlık giderlerini azaltmak yönünden değerlidir.

Keywords

• Pnömoni
• NLR
• Prokalsitonin
• CRP

Comparison of procalcitonin, C-reactive protein, white blood cell counts and hemogram subparameters in community acquired pneumonia patients

Abstract

Aims: Pneumonia is a clinically and radiologically detected inflammation of the lungs. Most of the pneumonia patients are community-acquired pneumonia cases. Hemogram and C-reactive protein (CRP) are commonly used to support diagnosis and follow-up of treatment. Procalcitonin is less accessible and expensive. And the use of hemogram subparameters is not very common. The aim of this study was to research the relationship between procalcitonin, CRP, White Blood Cell count (WBC) and hemogram subparameters in patients with CAP and the efficacy of new hematologic rates in differential diagnosis. Methods: Patients who were diagnosed with community acquired pneumonia by applying to the chest diseases outpatient clinic of our hospital were retrospectively analyzed. 67 patients who were clinically and radiologically diagnosed without noticing male or female were included in our study. Anamnesis data and co-morbidities of the cases were questioned. Procalcitonin, CRP and hemogram (platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) were calculated and WBC value was examined) were recorded. The obtained data were evaluated statistically and compared in terms of variables. Results: The mean age of our patients was 57 (18-71) years; there were 41 (61.19%) female and 26 (38.81%) male patients. 36 (53.73%) of our patients had chronic diseases; 21 (31.34%) had heart disease, 23 (34.32%) had diabetes, and 6 (8.95%) had kidney failure. Patients; 48 (71.64%) procalcitonin, 56 (83.58%) CRP, 38 (56.71%) WBC, 52 (77.61%) NLR, 34 (50.74%) PLR and 38 (56.71%) MLR values were high. Procalcitonin, CRP and NLR values were significantly higher than other subparameters. The CRP and NLR values of patients with an additional chronic disease were higher than patients without co-morbidities. In the correlation analyses, there was a strong correlation between procalcitonin, CRP and NRL, but the correlation between the others was not significant. (p<0.001). Conclusion: Our study shows NLR from hemogram subparameters can be used safely in CAP patients. Procalcitonin is expensive test for. Considering that Procalcitonin is not available in primary care family health centers and CRP is found in some family health centers, the calculated use of NLR will support the diagnosis. Using fewer examinations in secondary and tertiary health facilities is also valuable in terms of reducing health costs.

Keywords

• Pneumonia
• NLR
• procalsitonin
• CRP

Supporting Institution

yok

Ethical Statement

form yükledim

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