THROMBOCYTE INDICES RELATION WITH GESTATIONAL HYPERTENSIVE DISORDERS

Yıl 2020, Cilt: 5 Sayı: 1, 121 - 130, 16.01.2020

Mustafa Ayhan Ekici , Mehmet Kayhan

https://doi.org/10.35232/estudamhsd.653993

Cited By: 1

Öz

The aim of this study to evaluate relationship between
thrombocyte indices, Red cell distribution width (RDW) and gestational
hypertensive disorders. This study is a retrospective cross sectional study
performed between 2009 - 2019.Total 583 pregnant women were included in this
study; 123 severe preeclampsia (PE), 175 mild-PE, 73 gestational hypertension
(GH), 41 chronic hypertension and 171 healthy pregnant women (control group).
Statistical Package for Social Science version 23.0 is used for statistical
analysis. Kolmogorov-Smirnov, Anova, Kruskal-Wallis and Mann Whitney U tests
are used for interpretation of data. Statistical significance is considered if
p < 0.05. Mean age and number of pregancies were indifferent among five
groups. Mean Platelet Volume (MPV) was significantly higher in severe-PE group
(p<0.001) and insignificantly different among mild-PE, GH, chronic
hypertension and control groups (p=0.116) . Platelet count (PC) was found
significantly lower in severe-PE group (p=0.01) and found indifferent among
mild-PE, GH, chronic hypertension and control groups (p=0.110). RDW was found
significantly higher in severe-PE group than other groups (p=0.01)and
significantly higher in mild-PE group than GH, chronic hypertension and control
groups (p=0.01) but insignificantly different among GH, chronic hypertension
and control groups (p=0.501). Platelet distribution width (PDW) was found
significantly lower in control group than other groups (p<0.001) and found
indifferent among mild-PE, GH, chronic hypertension and severe-PE groups
(p=0.621). Neutrophil lymphocyte ratio (NLR), hemoglobin, Plateletcrit and
Platelet lymphocyte ratio (PLR) were found unchanged among the groups. MPV,
RDW, PDW, NLR, PC, Plateletcrit and PLR were indifferent among GH and chronic
hypertension groups. MPV and RDW were found higher and PC was found lower in
severe-PE. RDW levels elevation was found higher in accordance with the
severity of preeclampsia. PDW was found higher in gestational hypertensive
disorders than healthy pregnant women.                        

Anahtar Kelimeler

Preeclampsia, hypertension, thrombocyte indices, MPV, PDW, RDW, NLR

GESTASYONEL HİPERTANSİF BOZUKLUKLAR ile TROMBOSİT BELİRTEÇLERİNİN İLİŞKİSİ / THROMBOCYTE INDICES RELATION WITH GESTATIONAL HYPERTENSIVE DISORDERS

Öz

Çalışmanın amacı trombosit indeksleri, eritrosit  dağılım genişliği (RDW) ve gestasyonel
hipertansif bozukluklar arasındaki ilişkiyi değerlendirmektir. Çalışma
2009-2019 yılları arasında yapılan retrospektif kesitsel bir çalışmadır. Toplam
583 hamile kadın çalışmaya dahil edildi; 123 şiddetli preeklampsi (PE), 175
hafif PE, 73 gestasyonel hipertansiyon (GH), 41 kronik hipertansiyon ve 171
sağlıklı gebe (kontrol grubu). Verilerin yorumlanmasında Kolmogorov-Smirnov,
ANOVA, Kruskal-Wallis ve Mann Whitney U testleri kullanılmıştır. İstatistiksel
anlamlılık p <0.05 olduğunda kabul edildi. Ortalama yaş ve gebelik sayısı
açısından beş grup arasında fark bulunmadı. Ortalama Trombosit Hacmi (MPV)
şiddetli PE grubunda anlamlı derecede yüksek (p <0.001) bulundu. Hafif PE,
GH, kronik hipertansiyon ve kontrol grupları arasında MPV değerleri anlamlı
derecede farklı değildi (p = 0.116). Trombosit sayısı (PC) şiddetli PE grubunda
anlamlı olarak düşük bulundu (p = 0.01). Hafif PE, GH, kronik hipertansiyon ve
kontrol grupları arasında PC değerleri arasında anlamlı farlılık bulunmadı
(p=0.110). RDW, şiddetli PE grubunda diğer gruplardan (p = 0.01), hafif PE
grubunda GH, kronik hipertansiyon ve kontrol gruplarından (p = 0.01) anlamlı
olarak daha yüksek bulundu. Gestasyonel hipertansiyon, kronik hipertansiyon ve
kontrol grupları arasında RDW değerleri anlamlı derecede farklı bulunmadı. (p=
0.501). Trombosit dağılım genişliği (PDW) kontrol grubunda diğer gruplara göre
anlamlı olarak düşük bulundu (p <0.001). Hafif PE, GH, kronik hipertansiyon
ve şiddetli PE grupları arasında PDW değerleri arasında farklılık bulunmadı (p
= 0.621). Nötrofil lenfosit oranı (NLR), hemoglobin, Trombosit ve Trombosit
lenfosit oranı (PLR) gruplar arasında farklılık göstermedi. MPV, RDW, PDW, NLR,
PC, Trombosit ve PLR değerleri GH ve kronik hipertansiyon grupları arasında
farlılık göstermedi. Şiddetli PE'de MPV ve RDW daha yüksek ve PC daha düşük
bulundu. Preeklempsi şiddeti arttıkça RDW düzeylerinde artış olmaktadır.
Gestasyonel hipertansif hastalıklarda RDW seviyeleri sağlıklı gebelerden daha
yüksek bulunmuştur.                                                

Anahtar Kelimeler

Preeklampsi, hipertansiyon, trombosit indeksleri, MPV, PDW, RDW, NLR

Kaynakça

• 1. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 07;183(1):S1–S22
• 2. Mol BW, Roberts CT, Thangaratinam S, Magee LA, de Groot CJ, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(10022):999–1011. doi: 10.1016/S0140-6736(15)00070-7.
• 3. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103(5 pt 1):981–991
• 4. 4. Macey MG, Bevan S, Alam S, Verghese L, Agrawal S, Beski S, et al. Platelet activation and endogenous thrombin potential in pre-eclampsia. Thromb Res [Internet]. 2010;125(3):e76–81.
• 5. 5. Jakobsen C, Larsen JB, Fuglsang J, Hvas A, Jakobsen C, Larsen JB, et al. Platelet function in preeclampsia – a systematic review and meta-analysis Platelet function in preeclampsia – a systematic review and meta-analysis. Platelets [Internet]. 2019;0(0):1–14.
• 6. 6. Güngör ZB, Ekmekçi H, Tüten A, Toprak S. Is there any relationship between adipocytokines and angiogenesis factors to address endothelial dysfunction and platelet aggregation in untreated patients with preeclampsia ? Arch Gynecol Obstet (2017) 296: 495
• 7. Surgit O, Pusuroglu H, Erturk M, Akgul O, Buturak A, Akkaya E, et al. Assessment of mean platelet volume in patients with resistant hypertension, controlled hypertension and normotensives. The Eurasian journal of medicine. 2015;47:79.
• 8. Bellos I, Fitrou G, Pergialiotis V, Papantoniou N, Daskalakis G. Mean platelet volume values in preeclampsia: A systematic review and meta-analysis. Pregnancy Hypertens. 2018 Jul;13:174–80.
• 9. Monteith C, Egan K, O’Connor H, Maguire P, Kevane B, Szklanna PB, et al. Early onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study. J Perinat Med. 2018 Nov;46(9):1010–5.
• 10. Practice ACoO. Practice bulletin# 33: diagnosis and management of preeclampsia and eclampsia. Obstetrics & Gynecology. 2002;99:159-67.
• 11. Han L, Liu X, Li H, Zou J, Yang Z, Han J. Blood Coagulation Parameters and Platelet Indices : Changes in Normal and Preeclamptic Pregnancies and Predictive Values for Preeclampsia. 2014;(Dd):1–14.
• 12. Yucel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017 Jan;7:29–32.
• 13. Kanat-pektas M, Yesildager U, Tuncer N, Arioz DT. Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre-eclampsia ? 2014;40(7):1840–5.
• 14. Karateke A, Kurt RK, Baloglu A. Relation of platelet distribution width (PDW) and platelet crit (PCT) to preeclampsia. Ginekol Pol. 2015 May;86(5):372–5.
• 15. Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014;175:107-11.
• 16. Doğan K, Guraslan H, Senturk MB, Helvacioglu C, İdil S, Ekin M. Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia? Hypertens Pregnancy [Internet]. 2015 Oct 2;34(4):434–42.
• 17. AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vascular health and risk management. 2016;12:477.
• 18. Serin S, Avci F, Ercan O, Kostu B, Bakacak M, Kiran H. Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia? Pregnancy Hypertens. 2016 Jan;6(1):22–5.
• 19. Kirbas A, Ersoy AO, Daglar K, Dikici T, Biberoglu EH, Kirbas O, et al. Prediction of preeclampsia by first trimester combined test and simple complete blood count parameters. Journal of clinical and diagnostic research: JCDR. 2015;9:QC20.
• 20. Akıl MA, Bilik MZ, Acet H, Tunç SY, Ertaş F, Aydın M, et al. Mean platelet volume and neutrophil lymphocyte ratio as new markers of preeclampsia severity. Age (years). Koşuyolu Hearth Journal 2015;18(2):84-8
• 21. Gogoi P1, Sinha P1, Gupta B2, Firmal P2, Rajaram S2 . Neutrophil-to-lymphocyte ratio and platelet indices in pre-eclampsia. Int J Gynaecol Obstet. 2019 Jan;144(1):16-20.
• 22. Adam I, Mutabingwa TK, Malik EM. Red cell distribution width and preeclampsia: a systematic review and meta-analysis.Clin Hypertens. 2019 Jul 15;25:15.