Multipl Skleroz Hastalarında Trombosit Endekslerinin ve Klinik Bulgular ile İlişkilerin Değerlendirilmesi

Giriş ve Amaç: Multipl skleroz (MS) patogenezinde trombositlerin rolü, henüz tam olarak aydınlatılmamakla birlikte çeşitli çalışmalarda trombosit aktivitesinin artmış olduğu ileri yöntemlerle gösterilmiştir. Klinik pratikte trombosit aktivitesi ile ilgili bilgi verecek kolay ve hızlı yöntem, trombosit endekslerinin hesaplaması olabilir. Biz bu çalışmada, MS hastalarında trombosit endekslerini ve onların klinik bulgularla ilişkilerini değerlendirmeyi amaçladık. Yöntemler: Çalışmaya, 126 MS hastası ile yaş ve cinsiyet açısından eşleştirilmiş 127 kontrol birey dahil edilmiştir. Multipl skleroz hastalarının lökosit, nötrofil, lenfosit, trombosit (PLT) sayıları, ortalama trombosit hacmi (MPV), trombosit dağılım genişliği (PDW), plateletkrit (PCT) ve bu değerlerin oranları kontrol grubundaki veriler ile karşılaştırılmış, MS klinik bulguları ile ilişkileri değerlendirilmiştir. Bulgular: Multipl skleroz grubunda kontrol grubuna göre lökosit, lenfosit ve nötrofil sayısı düşük, MPV, PDW, PDW/PLT, PLT indeksi, platelet lenfosit oranı (PLR), nötrofil lenfosit oranı (NLR) ve platelet nötrofil oranı (PNR) değerleri anlamlı yüksek bulunmuştur. Tedavi alan MS grubunda lökosit, lenfosit ve nötrofil değerleri MS tedavisi almayan gruba göre anlamlı düşük, PLR ve PNR değerleri anlamlı yüksek saptanmıştır. MPV, PDW, PDW/PLT, NLR ve PLT indeksi açısından tedavi alan ve almayan MS grupları arasında anlamlı fark saptanmamıştır. Tartışma ve Sonuç: Bu çalışmada MS hastalarında trombosit aktivitesinin artmış olduğu, bu aktivitenin hemogramdaki trombosit parametreleri ile tespit edilebildiği ve modifiye edici tedaviden (DMT) etkilenmediği gösterilmiştir. Ayrıca, immünomodulatör tedaviye rağmen NLR değerlerinin azalmadığı tespit edilmiştir. Kronik trombosit aktivasyonun ve enflamasyonun olması antiplatelet ilaçlarının kullanımı MS için potansiyel bir tedavi yaklaşımını gerekli kılmaktadır.

Anahtar Kelimeler:

Multipl Skleroz, Trombosit Endeksleri, Trombosit Aktivitesi, Multipl Skleroz, Trombosit Endeksleri, Trombosit Aktivitesi

The Measurement of Neutrophil Gelatinase Associated Lipocalin in Umbilical Cord Blood and the Assessment of Its Relationship with Neonatal Results

Objectives: In this study, the relationship of cord blood Neutrophil Gelatinase-Associated Lipocalin (NGAL) with neonatal diseases was investigated. Methods: NGAL levels were measured in the cord blood of 180 babies born between 2015 and 2016. Patients were classified according to maternal diseases, neonatal diseases and demographic characteristics. Obtained data were compared with cord blood NGAL levels. Results: In our study, the mean NGAL levels were 1283.99 ng/mL in boys and 1306.52 ng/mL in girls. Umbilical cord blood NGAL levels of infants diagnosed with intrauterine growth retardation (1913.4±2833.5 ng/mL) and prolonged premature rupture of membranes (2594.2±2037.1 ng/mL) were found to be statistically high (p0.05). Conclusions: Neutrophil Gelatinase-Associated Lipocalin, may be useful as a diagnostic biomarker in the evaluation of maternal and neonatal diseases. However, studies on larger patient populations are needed.

Keywords:

Neutrophil Gelatinase Associated Lipocalin, umbilical cord blood, newborn,

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