Akut İskemik İnme Vakalarında Radyolojik Görüntüleme ve Laboratuvar Değerlerinin Analizi

Year 2024, Volume: 34 Issue: 2, 171 - 180, 30.04.2024

Mustafa Alpaslan , Necmi Baykan

https://doi.org/10.54005/geneltip.1315349

Abstract

Giriş: Akut iskemik inmeye bağlı ölüm ve sakatlık oranı dünyada ikinci sırada yer almaktadır. Bu çalışmada, iskemik inme geçiren hastalarda demografik özellikler ve etiyolojide yer alan ek hastalıklar ile yapılan radyolojik görüntüleme ve laboratuvar değerlerinin analizinin yapılması planlandı.
Gereç ve Yöntem: Bu çalışma retrospektif olarak 01.01.2022-31.12.2022 tarihleri arasında acil servisten iskemik inme teşhisi ile hastaneye yatırılan hastaların analizi ile yapılmıştır. Hastalarda rutin laboratuvar değerleri, lipitler, vitamin düzeyleri, radyolojik görüntülemeler ve etiyolojiye yönelik testler analiz edilmiştir.
Bulgular: Çalışmada 177 hasta analiz edildi. Hastaların %53,1’i erkekti. Yaş ortalaması 75±12,75 oldu. Ek hastalık olarak en sık hipertansiyon, diyabet ve hiperlipidemi olduğu görüldü. İskemik infarkt olarak en sık orta serebral arterin beslediği alanlarda tutulum görüldü. Hastalarda yapılan karotis ve/veya vertebral doppler ultrasonografide damarlarda %83,1 oranında plak olduğu görüldü. Transtorasik ekokardiyografi bulgularına göre hastaların %79,3’ünde kalp kapak patolojisi olduğu saptandı. Hastalarda patolojik olarak çoğunlukta hiperglisemi, D vitamini eksikliği ve HDL kolesterol seviyesinde düşüklük olduğu gözlendi. Altı hastada trombolitik tedavi uygulandı ve üç hasta fayda görürken bir hasta kanama gelişerek öldü. Hastaların %13,6’sı yoğun bakımda tedavi edildi.
Sonuç: İskemik inme görülme riski ileri yaşlarda artmaktadır. Hipertansiyon ve diyabet en önemli risk faktörlerindendir. Vitamin D ve vitamin B12 eksikliği ile folik asit eksikliği ateroskleroz açısından risk arz etmektedir. Aynı zamanda düşük HDL kolesterol düzeyi de inme riskini artırmaktadır. Etiyolojide önlenebilir nedenler olarak değerlendirilen bu faktörler tedavi ile kontrol altına alınmalıdır.

Keywords

acil servis, Akut iskemik inme, serebrovasküler hastalık

Radiological Imaging and Analysis of Laboratory Values in Case of Acute Ischemic Stroke

Abstract

Background: The rate of death and disability due to acute ischemic stroke ranks second in the world. In this study it was planned to analyze the demographic characteristics and additional diseases in the etiology as well as radiological imaging and laboratory values in patients with ischemic stroke.
Materials and Methods: This study was conducted retrospectively by analyzing the patients hospitalized with the diagnosis of ischemic stroke from the emergency department between 01.01.2022 and 31.12.2022. Routine laboratory values, lipids, vitamin levels, radiological imaging and tests for etiology were analyzed in the patients.
Results: One hundred seventy seven patients were analyzed in the study. 53.1% of the patients were male. The mean age was 75±12.75 years. The most common comorbidities were hypertension, diabetes and hyperlipidemia. As ischemic infarction, involvement was most common in the areas fed by the middle cerebral artery. In the carotid and/or vertebral doppler ultrasonography performed in the patients, plaque was observed in the vessels at a rate of 83.1%. According to the transthoracic echocardiographic findings, 79.3% of the patients were found to have heart valve pathology. Pathologically the majority of patients had hyperglycemia, vitamin D deficiency and low HDL cholesterol levels. Thrombolytic therapy was applied in six patients and three patients benefited and one patient died due to bleeding. 13.6% of the patients were treated in the intensive care unit.
Conclusion: The risk of ischemic stroke increases in advanced age. Hypertension and diabetes are among the most important risk factors. Vitamin D and vitamin B12 deficiency and folic acid deficiency pose a risk in terms of atherosclerosis. At the same time, low HDL cholesterol levels increase the risk of stroke. These factors which are considered as preventable causes in etiology should be controlled with treatment.

Keywords

Emergency department, Acute ischemic stroke, Cerebrovascular disease

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