Bronşiolitli Çocuklarda Hastalık Aktivitesinin Değerlendirilmesinde Nötrofil / Lenfosit Oranı Yeni Bir Biyobelirteç Olabilir mi?

Yıl 2019, Cilt: 7 Sayı: 1, 13 - 18, 22.04.2019

Eda Çelik Güzel , Çiğdem Fidan , Savaş Güzel , Cem Paketçi Aliye Çelikkol

Öz

Amaç:
Akut bronşiolit, inflamatuar bir hastalıktır.
Nötrofil/lenfosit oranı (NLO) çeşitli inflamatuar hastalıklarda arttığı bilinen
inflamatuar belirteçlerdir. Bu çalışmada amacımız bronşiolitli
çocuk hastalarda NLO değerlerini
incelemek ve hastalık şiddetiyle ilişkisini değerlendirmektir. 

Materyal
ve Metod: Çalışma akut bronşiolit tanısı alan 3 ay ile 5 yaş
arasında 77 hasta ve 34 sağlıklı çocuktan oluşturuldu. Hasta ve kontrol
grubunda C-reaktif protein (CRP), beyaz küre sayısı (BKS), ortalama trombosit
hacmi (OTH), nötrofil ve lenfosit değerleri ile birlikte NLO değerleri
incelendi. 

Bulgular: Akut bronşiolit
grubunda CRP, BKS, NLO ve nötrofil sayısı kontrol grubuna göre anlamlı olarak
yüksek saptandı (sırasıyla p<0.01, p<0.001, p<0.001, p<0.001 ). OTH
düzeyleri hasta grubunda anlamlı olarak düşük bulundu (p<0.05). Hastalık
şiddetine göre hasta grubu hafif, orta ve ağır olmak üzere üç gruba ayrıldı. Ağır
bronşiolitli hastalarda (n=21); nötrofil ve NLO değerleri hafif bronşiolitli
gruba (n=25) göre anlamlı olarak yüksek saptandı (Her ikisi de p<0.05).
Korelasyon analizinde; NLO ile OTH, BKS, CRP arasında pozitif korelasyon
saptandı (sırasıyla r=0.262–p<0.05; r=0.454–p<0.001; r=0.706–p<0.001).
Akut bronşiolitli hastaların hastaneye kabulde incelenen parametrelerden
yalnızca CRP için Receiver-operating characteristic (ROC) analizinde eğri
altında kalan alan (EAA) sonuçları tanısal olarak yeterli bulunurken (EAA=0.812),
BKS ve NLO için yeterlilik saptanamadı (sırasıyla EAA=0.692, EAA=0.583).

Sonuç: Çalışmamızda, hastaneye başvuruda saptanan
artmış CRP düzeylerinin; bronşiolit gelişecek hastaları predikte etmede ve
artmış NLO oranının hastalık şiddetinin belirlenmesinde iyi
bir belirteç olabileceğini göstermektedir.

Anahtar Kelimeler

Bronşiolit, İnflamasyon, Nötrofil

Kaynakça

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