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Ağır preeklampsiyi öngörmede hemogram inflamatuar belirteçlerin önemi

Yıl 2022, Cilt 13, Sayı 45, 86 - 96, 07.04.2022
https://doi.org/10.17944/mkutfd.1034264

Öz

Amaç: Çalışmamızda, gebeliğinde preeklampsi tanısı alan hastaların hemogram sonuçlarındaki inflamasyon belirteçlerden nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR) ve monosit/lenfosit oranı (MLR) nın değerlendirilmesi ve hafif-ağır preeklampsi gelişme ihtimali olan gebeleri, normal gebelerle karşılaştırarak hafif-ağır preeklampsiyi öngörebilmedeki yerinin belirlenmesi amaçlanmıştır. Yöntem: 148 ağır preeklampsili, 160 hafif preeklampsili olmak üzere toplam 308 preeklampsili ve 308 sağlıklı normotansif gebe olgusunun demografik verileri ve laboratuar testleri retrospektif olarak incelendi. Gruplar NLR, PLR ve MLR açısından incelendi. Bulgular: Gruplar arasında yaş bakımından fark bulunmadı. Preeklampsi grubunda parite, gestasyonel yaş, doğum kilosu ve APGAR skorları kontrol grubuna kıyasla düşüktü (p<0.001). NLR preeklampsi grubunda kontrol grubuna kıyasla istatistiksel anlamlı derecede yüksek bulundu (p<0.001). PLR’ de anlamlı derecede düşük olarak bulundu (p<0.001). MLR de gruplar arasında anlamlı fark saptanmadı. Sonuç: NLR ve PLR preeklampsi varlığının gösterilmesinde bir parametre olarak kullanılabilir. MLR için istatistiksel anlamlı sonuç saptanmadı.

Kaynakça

  • Hebisch G. Hypertonie und Schwangerschaft. Praxis. 2003;92:2137-43.
  • Sağol S, Özkınay E. Lipid Peroxidation In The Etiopathogenesis Of Preeclampsia. Journal of Clinical Obstetrics & Gynecology. 2000;10(1):7 - 15.
  • Ray JG, Wanigaratne S, Park AL, Bartsch E, Dzakpasu S, Urquia ML. Preterm preeclampsia in relation to country of birth. Journal of perinatology : official journal of the California Perinatal Association. 2016;36(9):718-22.
  • Lenfant C. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. 2000. Am J Obstet Gynecol 183: S1-S22. Journal of clinical hypertension (Greenwich, Conn). 2001;3:75-88.
  • The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114(Supplement 2):555-76.
  • Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. Obstetrics & Gynecology. 2020;135(6):1492-5.
  • Çankaya A, Savan K. Preeklampsi ve Normal Gebelik Olgular›nda Plasenta Lokalizasyonunun Uterin Arter Doppler S/D Oranlar›na Etkisi. Perinatoloji Dergisi. ARALIK 1999;7(4):315-8.
  • Naljayan MV, Karumanchi SA. New developments in the pathogenesis of preeclampsia. Advances in chronic kidney disease. 2013;20(3):265-70.
  • Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C, et al. The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. BMJ (Clinical research ed). 2005;330(7491):576-80.
  • Lindheimer MD, Taler SJ, Cunningham FG. ASH Position Paper: Hypertension in Pregnancy. The Journal of Clinical Hypertension. 2009;11(4):214-25.
  • Duan D-M, Niu J-M, Lei Q, Lin X-H, Chen X. Serum levels of the adipokine chemerin in preeclampsia. J Perinat Med [Internet]. 2012 2012/02//; 40(2):[121-7 pp.]. Available from: http://europepmc.org/abstract/MED/22117111 https://doi.org/10.1515/JPM.2011.127.
  • Luis B, Alice S-S, Alexandre Q, Irene R. Similarities Between Pre-Eclampsia and Atherosclerosis: A Protective Effect of Physical Exercise? Current Medicinal Chemistry. 2008;15(22):2223-9.
  • Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and gynecology. 2013;122(5):1122-31.
  • Redman CW, Sargent IL. Placental stress and pre-eclampsia: a revised view. Placenta. 2009;30 Suppl A:S38-42.
  • Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation. 2011;123(24):2856-69.
  • Laresgoiti-Servitje E, Gómez-López N, Olson DM. An immunological insight into the origins of pre-eclampsia. Human reproduction update. 2010;16(5):510-24.
  • Svensson-Arvelund J, Ernerudh J, Buse E, Cline JM, Haeger JD, Dixon D, et al. The placenta in toxicology. Part II: Systemic and local immune adaptations in pregnancy. Toxicologic pathology. 2014;42(2):327-38.
  • Faas MM, Spaans F, De Vos P. Monocytes and macrophages in pregnancy and pre-eclampsia. Frontiers in immunology. 2014;5:298.
  • Zhang WW, Liu KJ, Hu GL, Liang WJ. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients. Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine. 2015;36(11):8831-7.
  • Seckin KD, Karslı MF, Yucel B, Bestel M, Yıldırım D, Canaz E, et al. The utility of tumor markers and neutrophil lymphocyte ratio in patients with an intraoperative diagnosis of mucinous borderline ovarian tumor. European journal of obstetrics, gynecology, and reproductive biology. 2016;196:60-3.
  • Pek E, Beyazit F, Korkmaz NS. Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis. Pakistan journal of medical sciences. 2021;37(1):250-5.
  • Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L. Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy. International journal of environmental research and public health. 2015;12(8):10009-19.
  • Kocas C, Yildiz A, Abaci O, Karaca OS, Firdin N, Dalgic Y, et al. Platelet-to-Lymphocyte Ratio Predicts Contrast-Induced Nephropathy in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. Angiology. 2015;66(10):964-8.
  • Ayhan SS, Oztürk S, Erdem A, Ozlü MF, Ozyaşar M, Erdem K, et al. [Relation of neutrophil/lymphocyte ratio with the presence and severity of coronary artery ectasia]. Turk Kardiyol Dern Ars. 2013;41(3):185-90.
  • Sari I, Sunbul M, Mammadov C, Durmus E, Bozbay M, Kivrak T, et al. Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography. Kardiologia polska. 2015;73(12):1310-6.
  • Kurtoglu E, Kokcu A, Celik H, Tosun M, Malatyalioglu E. May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet. 2015;28(1):97-9.
  • Yavuzcan A, Cağlar M, Ustün Y, Dilbaz S, Ozdemir I, Yildiz E, et al. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekologia polska. 2014;85(3):197-203.
  • Kirbas A, Biberoglu E, Daglar K, İskender C, Erkaya S, Dede H, et al. Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy. European journal of obstetrics, gynecology, and reproductive biology. 2014;180:12-5.
  • Wang J, Zhu QW, Cheng XY, Liu JY, Zhang LL, Tao YM, et al. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. Journal of reproductive immunology. 2019;132:29-34.
  • Serin S, Avcı F, Ercan O, Köstü B, Bakacak M, Kıran H. Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy hypertension. 2016;6(1):22-5.
  • Sachan R, Patel M, V, Sachan P, Shyam R. Diagnostic accuracy of neutrophil to lymphocyte ratio in prediction of nonsevere preeclampsia and severe preeclampsia. Journal of Current Research in Scientific Medicine. 2017;3(2):79-83.
  • Zheng WF, Zhan J, Chen A, Ma H, Yang H, Maharjan R. Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: A PRISMA-compliant systematic review and meta-analysis. Medicine. 2019;98(51):e18496.
  • Panwar M, Kumari A, Hp A, Arora R, Singh V, Bansiwal R. Raised neutrophil lymphocyte ratio and serum beta hCG level in early second trimester of pregnancy as predictors for development and severity of preeclampsia. Drug discoveries & therapeutics. 2019;13(1):34-7.
  • Mannaerts D, Heyvaert S. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? 2019;32(9):1412-9.
  • Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy hypertension. 2017;7:29-32.

Predicting Severe Preeclampsia Importance of Hemogram Inflammatory Markers

Yıl 2022, Cilt 13, Sayı 45, 86 - 96, 07.04.2022
https://doi.org/10.17944/mkutfd.1034264

Öz

Objective: In our study, we evaluated the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) among the inflammation markers in the hemogram results of patients diagnosed with preeclampsia in pregnancy and compared the pregnant women with the possibility of developing mild, severe preeclampsia It is aimed to determine its place in predicting mild, severe preeclampsia. Method: The demographic data and laboratory tests of 308 preeclampsia and 308 healthy normotensive pregnant cases, 148 severe preeclampsia, 160 mild preeclampsia, were evaluated retrospectively. Groups were examined in terms of NLR, PLR and MLR. Results: There was no difference for age between the groups. In the preeclampsia group, parity, gestational age, birth weight and APGAR scores were lower than the control group (p<0.001). The NLR was found to be significantly higher (p<0.001) and PLR was significantly lower in the preeclampsia group compared to the control group (p<0.001). There was no significant difference between the groups in MLR. Conclusion: NLR and PLR can be used as a parameter to show the presence of preeclampsia. There was no statistically significant result for MLR.

Kaynakça

  • Hebisch G. Hypertonie und Schwangerschaft. Praxis. 2003;92:2137-43.
  • Sağol S, Özkınay E. Lipid Peroxidation In The Etiopathogenesis Of Preeclampsia. Journal of Clinical Obstetrics & Gynecology. 2000;10(1):7 - 15.
  • Ray JG, Wanigaratne S, Park AL, Bartsch E, Dzakpasu S, Urquia ML. Preterm preeclampsia in relation to country of birth. Journal of perinatology : official journal of the California Perinatal Association. 2016;36(9):718-22.
  • Lenfant C. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. 2000. Am J Obstet Gynecol 183: S1-S22. Journal of clinical hypertension (Greenwich, Conn). 2001;3:75-88.
  • The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114(Supplement 2):555-76.
  • Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. Obstetrics & Gynecology. 2020;135(6):1492-5.
  • Çankaya A, Savan K. Preeklampsi ve Normal Gebelik Olgular›nda Plasenta Lokalizasyonunun Uterin Arter Doppler S/D Oranlar›na Etkisi. Perinatoloji Dergisi. ARALIK 1999;7(4):315-8.
  • Naljayan MV, Karumanchi SA. New developments in the pathogenesis of preeclampsia. Advances in chronic kidney disease. 2013;20(3):265-70.
  • Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C, et al. The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. BMJ (Clinical research ed). 2005;330(7491):576-80.
  • Lindheimer MD, Taler SJ, Cunningham FG. ASH Position Paper: Hypertension in Pregnancy. The Journal of Clinical Hypertension. 2009;11(4):214-25.
  • Duan D-M, Niu J-M, Lei Q, Lin X-H, Chen X. Serum levels of the adipokine chemerin in preeclampsia. J Perinat Med [Internet]. 2012 2012/02//; 40(2):[121-7 pp.]. Available from: http://europepmc.org/abstract/MED/22117111 https://doi.org/10.1515/JPM.2011.127.
  • Luis B, Alice S-S, Alexandre Q, Irene R. Similarities Between Pre-Eclampsia and Atherosclerosis: A Protective Effect of Physical Exercise? Current Medicinal Chemistry. 2008;15(22):2223-9.
  • Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and gynecology. 2013;122(5):1122-31.
  • Redman CW, Sargent IL. Placental stress and pre-eclampsia: a revised view. Placenta. 2009;30 Suppl A:S38-42.
  • Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation. 2011;123(24):2856-69.
  • Laresgoiti-Servitje E, Gómez-López N, Olson DM. An immunological insight into the origins of pre-eclampsia. Human reproduction update. 2010;16(5):510-24.
  • Svensson-Arvelund J, Ernerudh J, Buse E, Cline JM, Haeger JD, Dixon D, et al. The placenta in toxicology. Part II: Systemic and local immune adaptations in pregnancy. Toxicologic pathology. 2014;42(2):327-38.
  • Faas MM, Spaans F, De Vos P. Monocytes and macrophages in pregnancy and pre-eclampsia. Frontiers in immunology. 2014;5:298.
  • Zhang WW, Liu KJ, Hu GL, Liang WJ. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients. Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine. 2015;36(11):8831-7.
  • Seckin KD, Karslı MF, Yucel B, Bestel M, Yıldırım D, Canaz E, et al. The utility of tumor markers and neutrophil lymphocyte ratio in patients with an intraoperative diagnosis of mucinous borderline ovarian tumor. European journal of obstetrics, gynecology, and reproductive biology. 2016;196:60-3.
  • Pek E, Beyazit F, Korkmaz NS. Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis. Pakistan journal of medical sciences. 2021;37(1):250-5.
  • Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L. Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy. International journal of environmental research and public health. 2015;12(8):10009-19.
  • Kocas C, Yildiz A, Abaci O, Karaca OS, Firdin N, Dalgic Y, et al. Platelet-to-Lymphocyte Ratio Predicts Contrast-Induced Nephropathy in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. Angiology. 2015;66(10):964-8.
  • Ayhan SS, Oztürk S, Erdem A, Ozlü MF, Ozyaşar M, Erdem K, et al. [Relation of neutrophil/lymphocyte ratio with the presence and severity of coronary artery ectasia]. Turk Kardiyol Dern Ars. 2013;41(3):185-90.
  • Sari I, Sunbul M, Mammadov C, Durmus E, Bozbay M, Kivrak T, et al. Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography. Kardiologia polska. 2015;73(12):1310-6.
  • Kurtoglu E, Kokcu A, Celik H, Tosun M, Malatyalioglu E. May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet. 2015;28(1):97-9.
  • Yavuzcan A, Cağlar M, Ustün Y, Dilbaz S, Ozdemir I, Yildiz E, et al. Mean platelet volume, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in severe preeclampsia. Ginekologia polska. 2014;85(3):197-203.
  • Kirbas A, Biberoglu E, Daglar K, İskender C, Erkaya S, Dede H, et al. Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy. European journal of obstetrics, gynecology, and reproductive biology. 2014;180:12-5.
  • Wang J, Zhu QW, Cheng XY, Liu JY, Zhang LL, Tao YM, et al. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. Journal of reproductive immunology. 2019;132:29-34.
  • Serin S, Avcı F, Ercan O, Köstü B, Bakacak M, Kıran H. Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy hypertension. 2016;6(1):22-5.
  • Sachan R, Patel M, V, Sachan P, Shyam R. Diagnostic accuracy of neutrophil to lymphocyte ratio in prediction of nonsevere preeclampsia and severe preeclampsia. Journal of Current Research in Scientific Medicine. 2017;3(2):79-83.
  • Zheng WF, Zhan J, Chen A, Ma H, Yang H, Maharjan R. Diagnostic value of neutrophil-lymphocyte ratio in preeclampsia: A PRISMA-compliant systematic review and meta-analysis. Medicine. 2019;98(51):e18496.
  • Panwar M, Kumari A, Hp A, Arora R, Singh V, Bansiwal R. Raised neutrophil lymphocyte ratio and serum beta hCG level in early second trimester of pregnancy as predictors for development and severity of preeclampsia. Drug discoveries & therapeutics. 2019;13(1):34-7.
  • Mannaerts D, Heyvaert S. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? 2019;32(9):1412-9.
  • Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy hypertension. 2017;7:29-32.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Original Articles
Yazarlar

Umut KUDRET>
TC VAN İL SAĞLIK MÜDÜRLÜĞÜ BAŞKALE DEVLET HASTANESİ KADIN HASTALIKLARI VE DOĞUM KLİNİĞİ / VAN
0000-0003-4205-8326
Türkiye


Mustafa Doğan ÖZÇİL> (Sorumlu Yazar)
HATAY MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
0000-0002-0232-9403
Türkiye

Destekleyen Kurum yoktur
Proje Numarası yoktur
Teşekkür Bu çalışmaya katkısı olan başta Anabilim Dalı Başkanımız Prof.Dr.Ali Ulvi Hakverdi olmak üzere tüm öğretim üyelerimize, İstatistik bölümünde bize yardımcı olan Dr.Öğretim Üyesi Memet Karadağa teşekkür ederiz.
Yayımlanma Tarihi 7 Nisan 2022
Başvuru Tarihi 8 Aralık 2021
Kabul Tarihi 5 Mart 2022
Yayınlandığı Sayı Yıl 2022, Cilt 13, Sayı 45

Kaynak Göster

Vancouver Kudret U. , Özçil M. D. Ağır preeklampsiyi öngörmede hemogram inflamatuar belirteçlerin önemi. The Medical Journal of Mustafa Kemal University. 2022; 13(45): 86-96.