AKUT APANDİSİT OLGULARINDA YAŞ GRUPLARI ARASINDA NÖTROFİL/LENFOSİT ORANLARI İLE HİSTOPATOLOJİK TANI ARASINDAKİ İLİŞKİNİN İNCELENMESİ

Yıl 2021, Cilt: 23 Sayı: 2, 206 - 210, 31.08.2021

Tayfun Bilgiç , Ali Sürmelioğlu

https://doi.org/10.24938/kutfd.865629

Öz

Amaç: Bu çalışmada akut apandisit tanısı ile opere edilen 65 yaş altı ve 65 yaş üstü hastalarda kan sayımı parametreleri, C- reaktif protein değeri, nötrofil/lenfosit oranları ve patolojik apandisit tanısının ilişkisinin incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Hastanemizde 2018-2020 yılları arasında akut apandisit tanısı ile opere edilmiş hastalar çalışmaya dahil edilmiştir. Hastalar 18-64 yaş ve 65 yaş üstü olarak iki gruba ayrılarak çalışma grubu oluşturulmuştur. Hastalara ait veriler hasta dosyalarından elde edilmiştir.
Bulgular: Hastanemizde opere edilen 18-64 yaş arası 119 kişi genç gruba ve 65 yaş ve üzeri 30 kişi yaşlı gruba dahil edilmiş olup toplamda 149 kişi çalışmaya katılmıştır. Nötrofil/lenfosit oranına bakıldığında; genç gruptaki hastaların yaşlı gruptaki hastalara göre daha yüksek nötrofil/ lenfosit oranına sahip olduğu görüldü (p=0.021). C-reaktif protein değerlerinin yaşlı grupta yer alan hastalarda genç gruptaki hastalara göre daha yüksek olduğu saptandı (p=0.009).
Sonuç: Nötrofil/lenfosit oranı ve C-reaktif protein değerleri akut apandisit tanısı için erken inflamatuvar belirteçlerdir. Altmış beş yaş altında nötrofil/lenfosit oranı değerinin, 65 yaş üstünde ise C-reaktif protein değerinin anlamlı düzeyde daha yüksek olduğu görülmüştür.

Anahtar Kelimeler

Akut Apandisit, C reaktif protein, nötrofil lenfosit oranı

Destekleyen Kurum

Hiçbir kurumdan mali anlamda destek alınmamıştır

Investigation of the Relationship Between Neutrophil/Lymphocyte Ratios and Histopathological Diagnosis Between Age Groups in Acute Appendicitis

Öz

Objective: The aim of this study was to investigate the relationship between blood count parameters, C-reactive protein, neutrophil/lymphocyte ratio and diagnosis of pathological appendicitis in patients under 65 and over 65 years of age who were operated with the diagnosis of acute appendicitis.
Material and Methods: Patients who were operated with the diagnosis of acute appendicitis in our hospital between 2018-2020 were included in the study. The study group was formed by dividing the patients into two groups as 18-64 years old and over 65 years old. The data of the patients were obtained from the patient medical records.
Results: In the study, 119 people between the ages of 18-64 were included in the younger group and 30 people aged 65 and over were included in the older group, and a total of 149 people were enrolled. When the neutrophil/lymphocyte ratio was examined, it was found that the younger group patients had higher mean values compared to the elderly group (p=0.021). It was found that C-reactive protein values were statistically higher in patients in the elderly group compared to the younger group (p=0.009).
Conclusion: Neutrophil/lymphocyte ratio and C-reactive protein values are early inflammatory markers for the diagnosis of acute appendicitis. It was observed that the neutrophil/lymphocyte ratio value under 65 years of age and the C-reactive protein value above the age of 65 were significantly higher.

Anahtar Kelimeler

acute appendicitis, , CRP, neutrophil/lymphocyte ratio

Kaynakça

• 1. Williams GR. Presidential Address: a history of appendicitis. With anecdotes illustrating its importance. Ann Surg. 1983;197(5):495-506.
• 2. Semm K. Endoscopic appendectomy. Endoscopy. 1983;15(2):59-64. Doi:10.1055/s-2007-1021466.
• 3. DeKoning EP. Acute appendicitis. In: Tintinalli JE, Stapczynski JS, Ma JO, Cline DM, Cydulka RK, Meckler GD, eds. Tintinalli’s Emergency Medicine. 7th ed. New York. Mc Graw Hill, 2011;574-84.
• 4. Ramdass MJ, Young Sing Q, Milne D, Mooteeram J, Barrow S. Association between the appendix and the fecalith in adults. Can J Surg. 2015;58(1):10-4.
• 5. Ellis H. Appendix. Maingot’s Abdominal Operations. 8th ed. Norwalk. Appleton-Century-Crofts, 1985.
• 6. Turhan AN, Kapan S. Akut apandisit. In: Ertekin C, Güloğlu R, Taviloğlu, eds. Acil Cerrahi. 1. baskı. İstanbul. Nobel Tıp Kitabevleri, 2009;299-316.
• 7. Kavic MS, Kavic SM. Laparoscopic appendectomy. In: Wetter PA, Kavic MS, Levinson CJ, Kelley WE, McDougall EM, Nezhat C, eds. Prevention and Management of Laparoendoscopic Surgical Complications. 3rd ed. Florida. Society of LaparoEndoscopic Surgeons Publising, 2010;239-48.
• 8. Martin RF. Acute appendicitis in adults: Clinical manifestations and differential diagnosis. UpToDate. Accessed date: 17 January 2021: https://www.uptodate.com/contents/acute-appendicitis-in-adults-clinical-manifestations-and-differential-diagnosis.
• 9. Liang MK, Andersson RE, Bernard M, Jaffe BM, Berger DH. The appendix. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE, eds. Schwartz’s Principles of Surgery. 10th ed. New York. McGraw-Hill Education, 2014;1241-62.
• 10. Beltrán MA, Almonacid J, Vicencio A, Gutiérrez J, Cruces KS, Cumsille MA. Predictive value of white blood cell count and C-reactive protein in children with appendicitis. J Pediatr Surg. 2007;42(7):1208-14.
• 11. Ishizuka M, Shimizu T, Kubota K. Neutrophil-to-lymphocyte ratio has a close association with gangrenous appendicitis in patients undergoing appendectomy. Int Surg. 2012;97(4):299-304.
• 12. Asfar S, Safar H, Khoursheed M, Dashti H, al-Bader A. Would measurement of C-reactive protein reduce the rate of negative exploration for acute appendicitis? J R Coll Surg Edinb. 2000;45(1):21-4.
• 13. Hallan S, Asberg A. The accuracy of C-reactive protein in diagnosing acute appendicitis--a meta-analysis. Scandinavian Journal of Clinical and Laboratory Investigation. 1997;57(5):373-380.
• 14. Jaffe BM, Berger DH. The Appendix. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE, eds. Schwartz’s Principles of Surgery. 8th ed. New York. McGraw-Hill Education, 2005;29:1119-37.
• 15. Chi CH, Shiesh SC, Chen KW, Wu MH, Lin XZ. C-reactive protein for the evaluation of acute abdominal pain. Am J Emerg Med. 1996;14(3):254-6.
• 16. Mengücük, ME, Ayten R, Bülbüller N, Gödekmerdan A, Başbuğ M, Mungan İ. Akut apandisit tanısında serum C-reaktif protein, prokalsitonin ve neopterinin yeri. Fırat Tıp Dergisi. 2010;15(1):40-43.
• 17. Eren T, Tombalak E, Burcu B, Özemir İA, Leblebici M, Ziyade S. Akut apandisit olgularında nötrofil/lenfosit oranının tanıda ve hastalığın şiddetini belirlemedeki prediktif değeri. Dicle Tıp Dergisi. 2016;43(2):279-84.
• 18. Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med. 1999;17(6):1019-25.
• 19. Yilmaz H, Ucan B, Sayki M, Unsal I, Sahin M, Ozbek M et al. Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity. Diabetes Metab Syndr. 2015;9(4):299-304.
• 20. Yazici M, Ozkisacik S, Oztan MO, Gürsoy H. Neutrophil/lymphocyte ratio in the diagnosis of childhood appendicitis. Turk J Pediatr. 2010;52(4):400-3.