Derya KARPUZ, Yalçın ÇELİK, Derya DUMAN, Fatma DURAK, Gülçin BOZLU, Dilek GİRAY, Baki KARA, Olgu HALLIOĞLU KILINÇ

Hipoksik iskemik ensefalopatili infantlarda tam kan sayımı parametreleri ve ekokardiyografi bulgularının prognostik değeri

Amaç: Bu çalışmanın amacı hipoksik iskemik ensefalopati(HİE) tanılı yenidoğanlarda tam kan sayımı parametrelerinin, pulmoner hipertansiyon (PH) ve kapak yetmezliği varlığının prognostik değerini incelemektir.Gereç ve Yöntem: Sarnat ölçeğine göre evre 2 ve 3 HİE olan 115 term yenidoğan ile 90 sağlıklı yenidoğan hastanın verileri retrospektif olarak değerlendirilmiştir. İlk 6 saatteki ve hipotermi tedavisi sonrası 72.saatteki ekokardiyografik inceleme, kırmızı kan hücresi dağılım genişliği (RDW), trombosit dağılımı genişliği (PDW) ve CRP değerleri, kontrol grubu ile karşılaştırılmıştır.Bulgular: Mitral yetmezlik, aortik yetmezlik ile persistan PH ve ölüm arasında anlamlı bir ilişki bulunmuştur. İlk 6 saat ve 72. saatteki ortalama RDW, PDW ve CRP değerleri kontrol sağlıklı gruba göre hastalarda daha yüksek çıkmıştır. Özellikle evre 3 HİE hastalarında daha belirgin olmak üzere, bu parametrelerin 72.saatte ilk 6 saate göre önemli oranda arttığı görülmüştür. RDW, CRP değerlerinde artış ile MY, AY olması ve mortalite arasında anlamlı bir ilişki bulunmuştur.Sonuç: Çalışmamız PH derecesi ve kapak yetmezliği varlığının, HİE’de prognozu belirlemede önemli parametreler olduğunu göstermektedir. RDW ve CRP gibi basit kan testleri ile ekokardiyografik değerlendirme yapılması yatış zamanı ve mortalite ile ilişkili olup prognozu belirlemede rehber olabilir.

Anahtar Kelimeler:

Echocardiography, Hypoxic-ischemic encephalopathy, Pulmonary hypertension, Red blood cell distribution width

Prognostic value of whole blood count parameters and echocardiographic findings in infants with hypoxic ischemic encephalopathy

Purpose: The aim of this study was to investigate the prognostic value of complete blood count parameters, presence of pulmonary hypertension (PH) and valve failure in newborns with hypoxic ischemic encephalopathy (HIE). Materials and Methods: 115 term newborns with Sarnat Stage 2 and 3 with HIE and 90 healthy newborns were included in this retrospective study. Echocardiographic examination, red blood cell distribution width (RDW), platelet distribution width (PDW), and C-reactive protein (CRP) values at the first six hours and at 72 hours after the cooling treatment were compared with controls.Results: There was a relationship between presence of mitral regurgitation (MR), aortic regurgitation (AR), and persistent PH and death. The mean RDW, PDW and CRP levels at the first six and after 72 hours were significantly higher in infants with HIE when compared with the control group, and these parameters were significantly increased in the stage 3 group. A significant relationship was found between the increase in RDW and CRP values and the presence of MR, AR and mortality.Conclusion: The degree of PH and presence of valvular insufficiency are important parameters in determining prognosis in HIE. Also, simple blood tests such as RDW and CRP and the echocardiographic evaluation are found to be correlated with hospitalization period and mortality and may be a guide in prognosis.

Keywords:

Echocardiography, Hypoxic-ischemic encephalopathy,

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