Febril Nötropenide C-Reaktif Protein ve Prokalsitoninin Yeri

Yıl 2009, Cilt: 7 Sayı: 2, 7 - 12, 01.09.2009

Özlem Özdemir Birol Baytan Metin Demirkaya Solmaz Çelebi

Öz

Amaç: Febril nötropeni kanser hastalarında en önemli mortalite ve morbidite nedenidir. Bu nedenle tanının erken konması ve uygun antibiyoterapinin başlanması oldukça önemlidir. Bu çalışmada febril nötropenik hastalarda C-reaktif protein CRP ve prokalsitonin arasında sepsisin şiddeti ve tanımlanmasında bir farklılıkolup olmadığını göstermek amaçlanmıştır. Gereç ve Yöntem: Bu prospektif çalışmaya Uludağ Üniversitesi Tıp Fakültesi Çocuk Hematoloji ve Onkoloji Ünitesinde febril nötropeni tanısıyla izlenen 30 olgu 35 atak dahil edildi. Serum CRP ve prokalsitonin değerleri 0-5. günlerde alındı.Kültür üremesi, uzamış ateş, mukozitin varlığı ve mutlak nötrofil sayısı MNS ilekarşılaştırma yapıldı. Bulgular: Akut lösemi tanısı alan 16 %54 ve solid tümörlü olan 14 %46 olgu incelendi. CRP ve prokalsitonin değerleri karşılaştırıldığında her iki parametrenin depik değerine 1. günde ulaştığı ve benzer zamanlarda azaldığı görüldü, ancak aralarında istatistiksel olarak anlamlı korelasyon saptanmadı r=0,2, p>0,05 . Mukoziti ve kültür üremesi olan hastalarda parametreler açısından anlamlı bir fark yoktu.Ancak CRP, MNS

Anahtar Kelimeler

Febril nötropeni, çocukluk çağı, C-reaktif protein, prokalsitonin

The Value of C-Reactive Protein and Procalcitonin in Febrile Neutropenia

Öz

Aim: Febrile neutropenia is the major cause of mortality and morbidity in cancerpatients. For this reason, early diagnosis of severe infections and appropriate antimicrobial therapy are very important. The aim of this study was to investigatethe difference between C-reactive protein CRP and procalcitonin in determiningthe sepsis and its severity. Materials and Method: A total of 30 children 35 episodes with febrile neutropeniawho were hospitalized in the Uludag University, Pediatric Hematology and Oncology Unit were included in this prospective study. The blood samples for CRP andprocalcitonin were collected daily between 0 to 5thdays. Serum CRP and procalcitonin levels were compared with culture positivity, prolonged fever, mucositisand absolute granulosit count AGC . Results: A total of 16 patients 56% diagnosed with acute leukemia and, 14 patients 46% having solid tumours were evaluated. In sequential analysis of febrileepisodes, both the median of procalcitonin and the CRP concentrations showedthe same tendency and there was no significant correlation between them r=0.2,p>0.05 . There was no significant association between CRP and procalcitoninamong those having positive culture and mucositis. However, CRP values at the3rd, 4thand 5thdays were significantly higher in the patients with AGC100/mm3. Similarly,CRP values were significantly higher at the 1st, 2nd, 3rdand 4thdays among the patients having prolonged fever. Conclusion: Our study suggests that there is no difference between CRP and procalcitonin in determining sepsis andits severity. Although procalcitonin is a valuable acute phase reactant in non-neutropenic patients, larger prospective

Anahtar Kelimeler

Febrile neutropenia, childhood, C-reactive protein, procalcitonin

Kaynakça

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