Evaluation of mean platelet volume and its ratio over platelet count in children with obstructive sleep apnea syndrome

Yıl 2015, Cilt: 25 Sayı: 1, 16 - 21, 10.02.2015

Harun Soyalıç Battal Tahsin Somuk Serkan Doğru Levent Gürbüzler Göksel Göktaş Ahmet Eyibilen

Öz

Objectives: This study aims to determine the association between obstructive sleep apnea syndrome OSAS caused by adenotonsillar hypertrophy and mean platelet volume MPV and MPV/platelet count ratio in children, and to evaluate the impact of adenotonsillectomy on these two parameters. Patients and Methods: This prospective study consisted of 73 child patients 38 boys, 35 girls; mean age 8.6±3.3 years, range 2 to 17 years with chronic adenotonsillar hypertrophy who applied to Gaziosmanpaşa University Faculty of Medicine, Ear, Nose and Throat policlinics due to witnessed apnea and snoring in January 2011 and January 2013. Also, 56 age and sex matched pediatric patients 28 boys, 26 girls; mean age 8.0±3.2 years; range 3 to 13 years who admitted to our clinic due to reasons besides OSAS were included in the study as control group. Preoperative and postoperative third month hemoglobin, white blood cell, thrombocyte count, and MPV values of the patients were recorded. Results: Although ratio of MPV/platelet count was higher in patient group than in control group, the difference was not statistically significant. Mean platelet volume level was 7.68±1.07 fL in patient group and 7.21±0.84 fL in control group. Preoperative MPV level in patient group was significantly higher than that in control group p<0.05 . A statistically significant decrease was detected in postoperative third month MPV level and platelet count compared with preoperative MPV and platelet count 7.68±1.07 fL and 7.17±0.97 fL, respectively; p<0.05 . Conclusion: High MPV and MPV/platelet count in children with adenotonsillar hypertrophy may be an important risk factor for cardiopulmonary and cerebrovascular morbidities which may develop both in childhood and in adulthood. Adenotonsillectomy may reduce this risk significantly.

Anahtar Kelimeler

Adenotonsillectomy, mean platelet volume, pediatric obstructive sleep apnea

Tıkayıcı uyku apne sendromu olan çocuklarda ortalama trombosit hacmi ve ortalama trombosit hacminin trombosit sayısına oranının değerlendirilmesi

Öz

Amaç: Bu çalışmada çocuklarda adenotonsiller hipertrofinin neden olduğu tıkayıcı uyku apne sendromu TUAS ile ortalama trombosit hacmi OTH ve OTH/trombosit sayısı oranı arasındaki ilişki belirlendi ve adenotonsillektominin bu iki parametre üzerindeki etkisi değerlendirildi.Hastalar ve Yöntemler: Bu prospektif çalışmaya Ocak 2011 - Ocak 2013 tarihleri arasında Gaziosmanpaşa Üniversitesi Tıp Fakültesi Hastanesi Kulak Burun Boğaz Polikliniği’ne tanıklı apne ve horlama nedeni ile başvuran, kronik adenotonsiller hipertrofisi olan 73 çocuk hasta 38 erkek, 35 kız; ort. yaş 8.6±3.3 yıl; dağılım 2-17 yıl dahil edildi. Ayrıca kliniğimize TUAS dışı nedenlerle başvuran, yaş ve cinsiyet uyumlu 56 çocuk hasta 28 erkek, 26 kız; ort. yaş 8.0±3.2 yıl; dağılım 3-13 yıl kontrol grubu olarak çalışmaya alındı. Hastaların ameliyat öncesinde ve ameliyat sonrası üçüncü ayda hemoglobin, beyaz kan hücresi, trombosit sayısı ve OTH değerleri kaydedildi.Bulgular: Hasta grubunda OTH/trombosit sayısı oranı kontrol grubuna göre yüksek olsa da fark istatistiksel olarak anlamlı değildi. Ortalama trombosit hacmi düzeyi hasta grubunda 7.68±1.07 fL, kontrol grubunda 7.21±0.84 fL idi. Ameliyat öncesi OTH düzeyi hasta grubunda kontrol grubundan anlamlı olarak yüksekti p

Anahtar Kelimeler

Adenotonsillektomi, ortalama trombosit hacmi, pediatrik tıkayıcı uyku apnesi

Kaynakça

• Alexander NS, Schroeder JW Jr. Pediatric obstructive sleep apnea syndrome. Pediatr Clin North Am 2013;60:827-40.
• Vlahandonis A, Walter LM, Horne RS. Does treatment of SDB in children improve cardiovascular outcome? Sleep Med Rev 2013;17:75-85.
• Varol E, Ozturk O, Gonca T, Has M, Ozaydin M, Erdogan D, et al. Mean platelet volume is increased in patients with severe obstructive sleep apnea. Scand J Clin Lab Invest 2010;70:497-502.
• Teo DT, Mitchell RB. Systematic review of effects of adenotonsillectomy on cardiovascular parameters in children with obstructive sleep apnea. Otolaryngol Head Neck Surg 2013;148:21-8.
• Kanbay A, Tutar N, Kaya E, Buyukoglan H, Ozdogan N, Oymak FS, et al. Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases. Blood Coagul Fibrinolysis 2013;24:532-6.
• Karakaş MS, Altekin RE, Baktır AO, Küçük M, Cilli A, Yalçınkaya S. Association between mean platelet volume and severity of disease in patients with obstructive sleep apnea syndrome without risk factors for cardiovascular disease. Turk Kardiyol Dern Ars 2013;41:14-20.
• Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta- analysis. J Thromb Haemost 2010;8:148-56.
• Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011;17:47-58.
• Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract 2009;63:1509-15.
• Cengiz C, Erhan Y, Murat T, Ercan A, Ibrahim S, Ihsan G, et al. Values of mean platelet volume in patients with chronic tonsillitis and adenoid hypertrophy. Pak J Med Sci 2013;29:569-72.
• Sagit M, Korkmaz F, Kavugudurmaz M, Somdas MA. Impact of septoplasty on mean platelet volume levels in patients with marked nasal septal deviation. J Craniofac Surg 2012;23:974-6.
• Sagit M, Cetinkaya S, Dogan M, Bayram A, Vurdem UE, Somdas MA. Mean platelet volume in patients with nasal polyposis. B-ENT 2012;8:269-72.
• Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, McGinn JT, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets 2011;22:557-66.
• Han JS, Park TS, Cho SY, Joh JH, Ahn HJ. Increased mean platelet volume and mean platelet volume/ platelet count ratio in Korean patients with deep vein thrombosis. Platelets 2013;24:590-3.
• Cho SY, Jeon YL, Kim W, Kim WS, Lee HJ, Lee WI, et al. Mean platelet volume and mean platelet volume/ platelet count ratio in infective endocarditis. Platelets 2014;25:559-61.
• Cho SY, Yang JJ, You E, Kim BH, Shim J, Lee HJ, et al. Mean platelet volume/platelet count ratio in hepatocellular carcinoma. Platelets 2013;24:375-7.
• Kucur C, Kulekci S, Zorlu A, Savran B, Oghan F, Yildirim N. Mean platelet volume levels in children with adenoid hypertrophy. J Craniofac Surg 2014;25:29-31.
• Yilmaz MD, Onrat E, Altuntaş A, Kaya D, Kahveci OK, Ozel O, et al. The effects of tonsillectomy and adenoidectomy on pulmonary arterial pressure in children. Am J Otolaryngol 2005;26:18-21.
• Varol E, Uysal BA, Ozaydin M. Platelet indices in patients with pulmonary arterial hypertension. Clin Appl Thromb Hemost 2011;17:171-4.