İleri derecede immatür bebeklerde trombosit lenfosit oranları (TLO) ile ağır intraventriküler hemoraji (IVH) ilişkisi

Year 2022, Volume: 32 Issue: 1, 84 - 88, 28.02.2022

Musa Silahlı

https://doi.org/10.54005/geneltip.979748

Abstract

Amaç: İntraventriküler hemoraji (IVH), özellikle çok düşük doğum ağırlıklı yeni doğanlarda prematüre doğumların ciddi bir komplikasyonudur. IVH’i tahmin edebilmek oldukça önemlidir. Bu çalışmada 28 hafta altında doğan prematüre bebeklerde doğumda bakılan trombosit lenfosit oranı (TLO) ve intraventriküler hemoraji (IVH) arasındaki ilişki incelenmek istenmiştir.
Gereç ve yöntem: Son 5 yılda hastanemizde yatan 28 hafta altı prematüre bebeklerin (n=78) dosyaları geriye dönük incelendi. Doğum sonrası bakılan tam kan verilerinden elde edilen parametreler ve özellikle TLO ve IVH arsındaki ilişki incelendi.
Bulgular: Beyaz küre ve lenfosit sayıları ciddi IVH’te (grade 3-4) anlamlı yüksek bulunurken, TLO anlamlı düşük bulunmuştur (sırasıyla 16048±5265 & 11972±10915, p=0,043; 10705±4537 & 6329±8101, p=0,007; 36,9±22,7 & 56,7±37,9 p=0,012). Beyaz küre, lenfosit sayısı ve TLO’nun ciddi IVH’i öngörmede tanısal performansları ROC eğrisi analizleri ile değerlendirildiğinde en güçlü performansın TLO’ya ait olduğu gözlemlendi (sırasıyla eğri altında kalan alan WBC: 0,644; ALS: 0.678; TLO:0,691). TLO kesme değeri 55,84 altındaki değerlerde %94 sensitivite ve %43 spesifite ile ağır IVH’i tahmin ettirebilir.
Sonuç: TLO ileri derecede immatur bebeklerde ciddi IVH’i öngörmede değerli bir belirteç olarak kullanılabilir.

Keywords

Intraventriküler kanama, Trombosit lenfosit oranı, prematüre

Supporting Institution

Bulunmamaktadır.

The association between platelet to lymphocyte ratio and intraventicular hemorrhage in extremely immature infants

Abstract

Aim: Intraventricular hemorrhage (IVH) is a serious complication of premature births, especially in newborns with very low birth weight. It's important to be able to predict IVH. In this study, the relationship between platelet lymphocyte rate (PLR) and intraventricular hemorrhage in premature infants born under 28 weeks was examined.
Material and methods: In the last 5 years, the medical records of infants with less than 28 weeks of gestational age (n=78) born in our hospital have been retrospectively examined. Obtained parameters from the whole blood count, especially the relationship between TLO and IVH were examined.
Results: White blood cell and lymphocyte counts were significantly higher in severe IVH (grade 3-4), while TLO was found to be significantly lower (16048±5265 & 11972±10915, p=0.043; 10705±4537 & 6329±8101, p=0.007; 36.9±22.7 & 56.7±37.9 p=0.012, respectively). When the white blood cell, lymphocyte count, and PLR's diagnostic performance in predicting severe IVH were evaluated by ROC curve analyses, it was observed that the strongest performance belonged to the PLR (Area under the curve, AUC for WBC: 0.644; ALS: 0.687; PLR:0,691, respectively). PLR can estimate severe IVH with 94% sensitivity and 43% specificity at a cut-off value below 55.84.
Conclusion: PLR can be used as a valuable marker for predicting IVH in extremely premature infants.

Keywords

platelet to lymphocyte ratio, intraventicular hemorrhage, premature

References

• Ballabh P. Intraventricular hemorrhage in premature infants: mechanism of disease. Pediatr Res. 2010;67:1-8.
• Duppré P, Sauer H, Giannopoulou EZ, et al. Cellular and humoral coagulation profiles and occurrence of IVH in VLBW and ELWB infants. Early Hum Dev. 2015;91:695-700.
• McCrea HJ, Ment LR. The diagnosis, management, and postnatal prevention of intraventricular hemorrhage in the preterm neonate. Clin Perinatol 2008; 35:777–92.
• Salonvaara M, Riikonen P, Kekomaki R, et al. Effects of gestational age and prenatal and perinatal events on the coagulation status in premature infants. Arch Dis Child Fetal Neonatal Ed 2003;88: F319–23.
• Linder N, Haskin O, Levit O, et al. Risk factors for intraventricular hemorrhage in very low birth weight premature infants: a retrospective case-control study. Pediatrics 2003;111: e590.
• Poralla C, Traut C, Hertfelder HJ, et al. The coagulation system of extremely preterm infants: influence of perinatal risk factors on coagulation. J Perinatol 2012; 32:869–73
• Wang Z, Peng S, Wang A, et al. Platelet lymphocyte ratio acts as an independent predictor of prognosis in patients with renal cell carcinoma. Clin Chim Acta. 2018; 480:166- 172.
• Chen H, Xue H, Liu W, et al. Meta-analysis of Platelet Lymphocyte Ratio as A Prognostic Factor for Non-small Cell Lung Cancer. Zhongguo Fei Ai Za Zhi. 2019; 22: 289-298.
• Shen Y, Huang X, Zhang W. Platelet-to-lymphocyte ratio as a prognostic predictor of mortality for sepsis: interaction effect with disease severity-a retrospective study. BMJ Open. 2019 25;9(1):e022896.
• Djordjevic D, Rondovic G, Surbatovic M, et al. Neutrophil-to-Lymphocyte Ratio, Monocyte-to Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia? Mediators Inflamm. 2018; 15;2018:3758068.
• Korkmaz L, Bastug O, Ozdemir A, et al. Can platelet mass index be a parameter to predict intraventricular hemorrhage in very-birth -weight newborns? Am J Perinatol. 2018; 36:1188– 97.
• Papille LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 gm. J Pediatr. 1978; 92:529–34.
• Templeton, G. F.. A Two-Step Approach for Transforming Continuous Variables to Normal: Implications and Recommendations for IS Research. Communications of the Association for Information Systems. 2011; 28, pp-pp. https://doi.org/10.17705/1CAIS.02804
• Khanafer-Larocque I, Soraisham A, Stritzke A, et al. Intraventricular Hemorrhage: Risk Factors and Association With Patent Ductus Arteriosus Treatment in Extremely Preterm Neonates. Front Pediatr. 2019; 7:408.
• Zhang W, Shen Y. Platelet-to-Lymphocyte Ratio as a New Predictive Index of Neurological Outcomes in Patients with Acute Intracranial Hemorrhage: A Retrospective Study. Med Sci Monit. 2018; 24:4413-4420.
• Go, H., Ohto, H., Nollet, K. E., et al. Using platelet parameters to anticipate morbidity and mortality among preterm neonates: a retrospective study. Frontiers in pediatrics, 2020, 8: 90
• Goksuluk D, Korkmaz S, Zararsiz G, Karaagaoglu AE. easyROC: An Interactive Web-tool for ROC Curve Analysis Using R Language Environment. The R Journal, 2016; 8:213-230.