Öz
ABSTRACT
Objective: The aim of the study is to determine the prognostic significance of NLR (neutrophil-lymphocyte ratio), PLR (platelet-lymphocyte ratio), MPV (mean platelet volume), RDW (red cell distribution) and PDW (platelet distribution width) values in Bell Paralysis(BP), a disease in which inflammatory processes are blamed in the pathogenesis, and whether these values have superiorities over each other.
Material and Methods: The study was carried out by retrospectively examining the files of 52 patients who were admitted to our clinic and diagnosed with BP (patient group) and 52 other control patients who were admitted to the outpatient clinic for routine health screening (control group). In our clinic, the evaluation of these patients is done in line with the House-Brackmann classification, by two different otorhinolaryngologists. All patients receive the same standard treatment. Those with trauma, Ramsey-Hunt syndrome, acute or chronic otitis media and facial paralysis due to tumor were excluded from the study. PDW, RDW and MPV values were obtained by the full blood count test; NLR and PLR values were obtained by calculation. All stated parameters were then compared.
Results: While the mean age was 53.38 ± 8.31 in the patient group, it was 36.50 ± 11.34 in the control group. While the mean lymphocyte level was 2.83 ± 1.13 in the patient group, it was 2.25 ± 0.65 in the control group, and a statistically significant difference was observed between the two groups (p = 0.002). There was no statistically significant difference between the patient group and the control group in terms of MPV, RDW, PDW values and between the groups in terms of response to treatment. Finally, the NLR was 1.85 ± 0.80 in the patient group, 2.07 ± 0.85 in the control group, the PLR was 109.91 ± 39.32 in the patient group, and 124.19 ± 40.25 in the control group, and no statistically significant difference was observed neither between the patient and control groups nor the treatment responsive and unresponsive patient groups in terms of both parameters.
Conclusion: Inflammatory parameters are not independent prognostic factors in BP however according to the literature, some may be associated with microvascular damage and increased inflammation. There is a need to reveal the pathogenesis of the disease better with future studies and to investigate different parameters that can determine the prognosis
Anahtar Kelimeler
Kaynakça
- 1. McCaul JA, Cascarini L, Godden D, et al. Evidencebasedmanagement of Bell'spalsy. Br J Oral MaxillofacSurg. 2014; 52: 387-91. doi: 10.1016/j.bjoms.2014.03.001.
- 2. Abdel-Razik A, Mousa N, Besheer TA, et al. Neutrophiltolymphocyteratio as a reliable marker top redict insülin resistance andfibrosis stage in chronichepatitis C virusinfection. ActaGastroenterolBelg. 2015; 78: 386-92.
- 3. Alan S, Tuna S, Türkoğlu EB. Therelation of neutrophil-to-lymphocyteratio, platelet-to-lymphocyte ratio, and mean platelet volüme with the presence andseverity of Behçet's syndrome. Kaohsiung J MedSci. 2015; 31: 626-31. doi: 10.1016/j.kjms.2015.10.010.
- 4. Demir AK, Demirtas A, Kaya SU,et al. The relationship between the neutrophil-lymphocyte ratio and disease activity in patients with ulcerativ ecolitis. Kaohsiung J MedSci. 2015; 31: 585-90. doi: 10.1016/j.kjms.2015.10.001.
- 5. Toprak C, Tabakci MM, Simsek Z,et al. Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention. Postepy Kardiol Interwencyjnej. 2015; 11: 288-97. doi: 10.5114/pwki.2015.55599.
- 6. Aldemir MN, Turkeli M, Simsek M, et al. Prognostic Value of Baseline Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in Localand Advanced Gastric Cancer Patients. Asian Pac J Cancer Prev. 2015; 16: 5933-7.
- 7. Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015; 7: 402-11.
- 8. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010; 14: 28-32. PMID: 20411056; PMCID: PMC2843567.
- 9. Takemoto N, Horii A, Sakata Y, et al. Prognostic factors of peripheral facial palsy: multivariate analysis followed by receiver operating characteristic and Kaplan-Meier analyses. Otol Neurotol. 2011; 32: 1031-6.
- 10. Ushio M, Kondo K, Takeuchi N, et al. Prediction of the prognosis of Bell's palsy using multivariate analyses. Otol Neurotol. 2008; 29: 69-72.
- 11. Horibe Y, Tanigawa T, Shibata R ,et al. Efficacy of the red blood cell distribution width for predicting the prognosis of Bellpalsy: a pilot study. Eur Arch Otorhinolaryngol. 2017; 274: 2303-2306. 12. Lippi G, Targher G, Montagnana M,et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009; 133: 628–632.
- 13. Bucak A, Ulu S, Oruc S et al Neutrophil-to-lymphocyte ratio as a novel-potential marker for predictingprognosis of Bell palsy. Laryngoscope. 2014; 124: 1678–1681.
- 14. Eryilmaz A, Basal Y, Tosun A, et al. The neutrophil to lymphocyte ratios of our pediatric patients with Bell’s palsy. Int J Pediatr Otorhinolaryngol. 2015; 79: 2374–2377.
- 15. Atan D, İkincioğulları A, Köseoğlu S, et al. New predictive parameters of Bell's Palsy: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Balkan Med J. 2015; 32: 167-70.
- 16. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011; 17: 47-58.
- 17. Işık M, Şahin H, Hüseyin E. New platelet indices as infammatory parameters for patients with rheumatoid arthritis. Eur J Rheumatol. 2014; 1: 144-146.
- 18. Ata E, Düzenli T. Fibromyalji tanısında inflamatuar bir belirteç: Platelet dağılım genişliği. Bozok Tıp Derg. 2019; 9: 73-7
BELL PARALİZİ OLAN HASTALARDA PDW, RDW VE MPV GİBİ BELİRTEÇLERİN PREDİKTİF DEĞERLERİ İLE BU DEĞERLERİN NLR VE PLR İLE KARŞILAŞTIRILMASI
Öz
Amaç: İnflamasyon temeline dayandırılan Bell paralizide NLR(nötrofil-lenfosit oranı), PLR(platelet-lenfosit oranı), MPV(ortalama platelet hacmi), RDW(kırmızı hücre dağılım genişliği) ve PDW(platelet dağılım genişliği) değerlerinin prognostik önemlerinin ve eğer varsa birbirlerine üstünlüklerinin olup olmadığının belirlenmesidir
Materyal Metod: Kliniğimize başvuran ve Bell paralizi tanısı konan 52 hastanın ve rutin sağlık taraması için polikliniğe başvuran ve hasta grubu ile cinsiyet açısından benzer 52 bireyden oluşan kontrol grubunun dosyaları retrospektif olarak incelenerek gerçekleştirildi. Kliniğimizde hastaların fasiyal paralizilerinin dereceleri iki ayrı Kulak Burun boğaz uzmanı tarafından House-Brackmann sınıflamasına göre yapılmaktadır. Klinik olarak bütün hastalara standart tedavi uygulanmaktadır. Travma, Ramsey-Hunt sendromu, akut veya kronik otitis media ve tümöre bağlı fasiyal paralizisi olanlar çalışma dışı bırakıldı. Hastaların tam kan sayımı incelemesinden PDW, RDW, MPV değerleri bakılarak; NLR ve PLR ise hesaplanarak tedavi ve kontrol grubu ile tedaviye yanıt veren ve vermeyen gruplar arasında karşılaştırması yapılmıştır.
Bulgular: Hasta grubunda ortalama yaş 53.38± 8.31 iken, kontrol grubunda 36.50 ± 11.34 idi. Ortalama lenfosit düzeyi hasta grubunda 2.83±1.13 bulunurken, kontrol grubunda 2.25±0.65 olarak bulundu ve iki grup arasında istatistiksel olarak anlamlı fark izlendi (p=0.002). MPV, RDW, PDW değerleri açısından hasta grubu ve kontrol grubu arasında arasında istatistiksel olarak anlamlı fark izlenmedi. Bu parametrelerin başvuru anındaki değerlerinin prognostik önemi açısından bakıldığında tedaviye yanıt veren ve vermeyen gruplar arasında da istatistiksel olarak anlamlı fark görülmedi. Son olarak hasta grubunda NLR 1.85 ± 0.80, kontrol grubunda 2.07 ± 0.85, yine hasta grubunda PLR 109.91 ± 39.32, kontrol grubunda 124.19 ± 40.25 izlendi ve her 2 parametre açısından da hasta ve kontrol grubu ile tedaviye yanıt veren ve vermeyen gruplar arasında istatistiksel anlamlı fark gözlenmedi.
Sonuç: İnflamatuar parametreler Bell paralizide kesin parognostik belirteç değildir ancak literatüre bakıldığında bazılarının mikrovasküler hasar ve artmış inflamasyonla ilişkili olduğu söylenebilir. Dolayısıyla bu hastalarda hastalığın patogenezinin yapılacak çalışmalarla daha iyi ortaya konması ve prognozu belirleyebilecek farklı parametrelerin araştırılmasına ihtiyaç duyulmaktadır.
Anahtar Kelimeler
Kaynakça
- 1. McCaul JA, Cascarini L, Godden D, et al. Evidencebasedmanagement of Bell'spalsy. Br J Oral MaxillofacSurg. 2014; 52: 387-91. doi: 10.1016/j.bjoms.2014.03.001.
- 2. Abdel-Razik A, Mousa N, Besheer TA, et al. Neutrophiltolymphocyteratio as a reliable marker top redict insülin resistance andfibrosis stage in chronichepatitis C virusinfection. ActaGastroenterolBelg. 2015; 78: 386-92.
- 3. Alan S, Tuna S, Türkoğlu EB. Therelation of neutrophil-to-lymphocyteratio, platelet-to-lymphocyte ratio, and mean platelet volüme with the presence andseverity of Behçet's syndrome. Kaohsiung J MedSci. 2015; 31: 626-31. doi: 10.1016/j.kjms.2015.10.010.
- 4. Demir AK, Demirtas A, Kaya SU,et al. The relationship between the neutrophil-lymphocyte ratio and disease activity in patients with ulcerativ ecolitis. Kaohsiung J MedSci. 2015; 31: 585-90. doi: 10.1016/j.kjms.2015.10.001.
- 5. Toprak C, Tabakci MM, Simsek Z,et al. Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention. Postepy Kardiol Interwencyjnej. 2015; 11: 288-97. doi: 10.5114/pwki.2015.55599.
- 6. Aldemir MN, Turkeli M, Simsek M, et al. Prognostic Value of Baseline Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in Localand Advanced Gastric Cancer Patients. Asian Pac J Cancer Prev. 2015; 16: 5933-7.
- 7. Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015; 7: 402-11.
- 8. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010; 14: 28-32. PMID: 20411056; PMCID: PMC2843567.
- 9. Takemoto N, Horii A, Sakata Y, et al. Prognostic factors of peripheral facial palsy: multivariate analysis followed by receiver operating characteristic and Kaplan-Meier analyses. Otol Neurotol. 2011; 32: 1031-6.
- 10. Ushio M, Kondo K, Takeuchi N, et al. Prediction of the prognosis of Bell's palsy using multivariate analyses. Otol Neurotol. 2008; 29: 69-72.
- 11. Horibe Y, Tanigawa T, Shibata R ,et al. Efficacy of the red blood cell distribution width for predicting the prognosis of Bellpalsy: a pilot study. Eur Arch Otorhinolaryngol. 2017; 274: 2303-2306. 12. Lippi G, Targher G, Montagnana M,et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009; 133: 628–632.
- 13. Bucak A, Ulu S, Oruc S et al Neutrophil-to-lymphocyte ratio as a novel-potential marker for predictingprognosis of Bell palsy. Laryngoscope. 2014; 124: 1678–1681.
- 14. Eryilmaz A, Basal Y, Tosun A, et al. The neutrophil to lymphocyte ratios of our pediatric patients with Bell’s palsy. Int J Pediatr Otorhinolaryngol. 2015; 79: 2374–2377.
- 15. Atan D, İkincioğulları A, Köseoğlu S, et al. New predictive parameters of Bell's Palsy: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Balkan Med J. 2015; 32: 167-70.
- 16. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011; 17: 47-58.
- 17. Işık M, Şahin H, Hüseyin E. New platelet indices as infammatory parameters for patients with rheumatoid arthritis. Eur J Rheumatol. 2014; 1: 144-146.
- 18. Ata E, Düzenli T. Fibromyalji tanısında inflamatuar bir belirteç: Platelet dağılım genişliği. Bozok Tıp Derg. 2019; 9: 73-7
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Nisan 2021 |
| Gönderilme Tarihi | 31 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 54 Sayı: 1 |
