Sistemik Lupus Eritematozus Hastalarında İnflamasyon Belirteci ve Yüksek Hastalık Aktivite Göstergesi Olarak Yeni Hematolojik İndeksler

Öz

Bu çalışmada, sistemik lupus eritematozus (SLE) hastalarında nötrofil/lenfosit (NLO), trombosit/lenfosit (PLO), monosit/lenfosit (MLO) oranı gibi hematolojik belirteçlere ek olarak sistemik inflamatuar indeks (Sİİ), sistemik inflamasyon yanıt indeksi (SİYİ) ve sistemik inflamasyon agregat indeksi (SİAİ) gibi yeni hematolojik belirteçlerin SLE’de inflamasyon belirteci olarak öneminin belirlenmesi, bu paramatrelerin SLE hastalık aktivitesi ile ilişkisinin değerlendirilmesi ve çok yüksek hastalığı göstermedeki duyarlılıklarının araştırılması amaçlandı. Çalışmaya 91 SLE hastası ve 100 sağlıklı kontrol dahil edildi. SLE hastalarının hastalık aktivitesini değerlendirmede Sistemik Lupus Eritematozus Hastalık Aktivite İndeksi 2000 (SLEDAI-2K) kullanıldı. SLE hastaları hastalık aktivitesine göre SLEDAI-2K <20 ve ≥20 olan hastalar olarak ikiye ayrıldı. SLE hastalarında hematolojik parametrelerin hepsi (NLO, PLO, MLO, Sİİ, SİYİ, SİAİ) sağlıklı kontrol grubu ile karşılaştırıldığında anlamlı olarak daha yüksek saptandı; sırasıyla (p<0.001, p<0.001, p=0.022, p=0.016, p<0.001, p=0.007). SLEDAI-2K≥20 olan hastalarda NLO (p=0.040), Sİİ (p=0.012), SİYİ (p=0.002) ve SİAİ (p=0.003) SLEDAI-2K<20 olan hastalara göre anlamlı olarak daha yüksekti. Hastalık aktivitesi ile NLO, Sİİ, SİYİ ve SİAİ arasında pozitif korelasyon izlendi; sırasıyla (r=0.216) (p=0.039), (r=0.265) (p=0.011), (r=0.3258) (p=0.002), (r=0.309) (p=0.003). Hematolojik parametrelerin çok yüksek hastalık aktivitesini tahmin etmede duyarlılıkları ROC eğrisi ile değerlendirildi. Duyarlılığı en yüksek olan parametreler SİYİ, SİAİ, Sİİ ve NLO idi. Bu çalışmada yeni hematolojik belirteçler olan Sİİ, SİYİ ve SİAİ’nin SLE hastalarında inflamasyonu göstermede etkili olduğu, çok yüksek hastalık aktivitesi ile ilişkili olduğu ve çok yüksek hastalık aktivitesini saptamada duyarlılığının yüksek olduğu gösterilmiştir.

Anahtar Kelimeler

• Sistemik lupus eritematozus
• Hastalık aktivitesi
• Sistemik inflamatuar indeks (SII)
• Sistemik inflamasyon yanıt indeksi (SIRI)
• Sistemik inflamasyon agregat indeksi (AISI)

New Hematological Indices as Markers of Inflammation and High Disease Activity in Patients With Systemic Lupus Erythematosus

Öz

(MLR) ratio, systemic inflammatory index (SII), systemic inflammation response index (SIRI), and systemic inflammation aggregate index (AISI) were evaluated in systemic lupus erythematosus (SLE) patients. It was aimed to determine the importance of new hematological markers as an inflammation marker in SLE, evaluate the relationship of these parameters with SLE disease activity (DA), and investigate their sensitivity in showing very high DA. 91 SLE patients and 100 healthy controls were included in the study. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) was used to evaluate the DA. SLE patients were divided into patients with SLEDAI-2K <20 and ≥20. NLR, PLR, MLR, SII, SIRI, AISI were all found to be significantly higher in SLE patients compared to the healthy controls; respectively (p<0.001, p<0.001, p=0.022, p=0.016, p<0.001, p=0.007). NLR (p=0.040), SII (p=0.012), SIRI (p=0.002) and AISI (p=0.003) were significantly higher in patients with SLEDAI-2K≥20 than patients with SLEDAI-2K<20. A positive correlation was observed between SLEDAI-2K and NLR, SII, SIRI and AISI; respectively (r=0.216) (p=0.039), (r=0.265) (p=0.011), (r=0.3258) (p=0.002), (r=0.309) (p=0.003). The sensitivity of hematological parameters to predict very high DA was evaluated with the ROC curve. SIRI, AISI, SII, and NLR had the highest sensitivity. In this study, it has been shown that the new hematological markers are effective in demonstrating inflammation in SLE, are associated with very high DA, and have a high sensitivity in detecting very high DA.

Anahtar Kelimeler

• Systemic lupus erythematosus
• Disease activity
• Systemic inflammatory index
• Systemic inflammatory response index
• Systemic inflammation aggregate index

Kaynakça

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