Toplum kökenli pnömonili çocuklarda hastalık aktivitesinin değerlendirilmesinde yeni bir biyobelirteç olarak C-reaktif protein (CRP)/ortalama trombosit hacmi (OTH) oranı

Amaç: Son yıllarda inflamasyon göstergesi olarak değerlendirilen C-reaktif proteinin (CRP)/ortalama trombosit hacmi (OTH) oranı ve beyaz küre sayısı (BKS)/ortalama trombosit hacmi (OTH) oranının toplum kökenli pnömonili (TKP) çocuklarda tanı ve hastalık şiddeti ile ilişkisini araştırmaktır.Gereç ve Yöntem: Çalışma TKP tanısı alan 3 ay ile 18 yaş arasında 60 hasta ve 30 sağlıklı çocuktan oluşturuldu. Hasta ve kontrol grubunda CRP, BKS, OTH, nötrofil/lenfosit oranı (NLO) değerleri ile birlikte CRP/OTH ve BKS/OTH değerleri incelendi. Bulgular: Hasta ve kontrol grubu arasında OTH düzeyleri açısından anlamlı fark saptanmazken, CRP/OTH, BKS/OTH, NLO ve plateletkrit düzeyleri hasta grubunda anlamlı olarak yüksek bulundu. Ciddi pnömonili hasta grubunda (n=27) BKS, NLO, BKS/OTH, CRP/OTH ve CRP düzeyleri hafif-ılımlı pnömonili gruba (n=33) göre anlamlı olarak yüksek saptandı. CRP/OTH ve BKS/OTH oranlarının hastalık belirtilerinin süresiyle arasında pozitif korelasyon gösterildi. Receiver Operating Characteric (ROC) analizinde CRP (Eğri altındaki alan (EAA)=0.801), BKS (EAA=0.761) ve BKS/OTH (EAA=0.731) düzeylerinin TKP’nin tanısında yeterliliği anlamlı bulundu. Ciddi TKP’li hastaların ayrımında ise CRP/OTH (EAA=0.733) ve CRP (EAA=0.708) düzeyleri anlamlı bulundu.Sonuç: CRP/OTH ve BKS/OTH oranları TKP tanısının değerlendirilmesinde ve CRP/OTH oranı hastalık aktivitesinin belirlenmesinde iyi bir belirteç olabileceğini göstermektedir.

Anahtar Kelimeler:

Pnömoni, C-reaktif protein, beyaz küre sayısı, ortalama trombosit hacmi, hastalık şiddeti

C-reactive protein (CRP)/mean platelet volume (MPV) ratio as a new biomarker for community-acquired pneumonia in children

Purpose: Our aim is to evaluate the relationship between C-reactive protein (CRP)/mean platelet volume (MPV) ratio and white blood cell (WBC)/mean platelet volume (MPV) ratio and diagnosis and disease severity in children with community-acquired pneumonia (CAP).Material and Methods: 60 patients with CAP including 33 mild-moderate (Group 1) and 27 severe pneumonia (Group 2) and 30 healthy children were examined for routine blood test. WBC, MPV, neuotrophile/lymhocyte ratio (NLR), CRP, WBC/MPV, CRP/MPV values were recorded on each patient and healthy groups.Result: CRP/MPV, WBC/MPV, NLR and plateletcrit values were significantly higher in patients group than controls, while MPV value is not correlated between patient and control groups. WBC, NLR, WBC/MPV, CRP/MPV and CRP values were higher in the Group 2 compared to Group 1. CRP/MPV and WBC/MPV were positively correlated with duration of symptoms in the CAP. The area under ROC curve of CRP, WBC and WBC/MPV in diagnosing CAP was significant (0.801, 0.761 and 0.731). Also the area under ROC curve of Group 2 in CRP/MPV and CRP in diagnosing CAP was significant (0.733, 0.708).Conclusion: CRP/MPV and WBC/MPV ratio may be used a marker in the evaluation of CAP diagnosis and CRP/MPV ratio can be good marker prediction of disease activity.

Keywords:

Pneumonia, C-reactive protein, white blood cell, mean platelet volume, disease severity,

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