Mehmet Emin MENGÜCÜK, REFİK AYTEN, Nurullah BÜLBÜLLER, Ahmet GÖDEKMERDAN, MURAT BAŞBUĞ, İbrahim MUNGAN

Akut apandisit tanısında serum C-reaktif protein, prokalsitonin ve neopterinin yeri

Amaç: Akut apandisitin özellikleri ve tedavisi tam olarak tanımlanmasına rağmen negatif apendektomi oranları yüksek olan acil cerrahi bir durumdur. Çeşitli inflamatuar belirteçler kullanılmakla birlikte özgül bir test yoktur. Bu çalışmada C-reaktif protein, prokalsitonin ve neopterinin akut apandisitte tek tek veya birlikte kullanımının tanıya katkısını ortaya koymayı planladık. Gereç ve Yöntemler: Fırat Üniversitesi Genel Cerrahi kliniğine karın sağ alt kadran ağrısı ile başvuran ve akut apandisit ön tanısıyla yatırılan 100 ardışık hasta takibe alındı. Hastalar beş gruba ayrıldı. Grup 1 (n:16):konservatif tedavi edilenler, grup 2 (n:6): patolojik olarak apandiksi normal olanlar, grup 3 (n:38): fokal apandisit olanlar, grup 4 (n:32): süpüratif apandisit olanlar, grup 5 (n:8): perfore apandisit olanlar. Tüm hastalarda başvuru anında serumda C-reaktif protein, prokalsitonin ve neopterinin çalışıldı. Bulgular: C-reaktif protein, prokalsitonin ve neopterinin seviyeleri grup 3'de grup 1'e göre anlamlı olarak yüksekti. Grup 4 ve grup 5'de C-reaktif protein ve prokalsitonin seviyeleri grup 1'e göre yüksek iken neopterin seviyelerinde anlamlı fark gözlenmedi. Grup 3 ve grup 4 arasında da her üç parametrede de farklılık gözlenmedi. Sonuç: Akut apandisitte serum C-reaktif protein, prokalsitonin ve neopterin seviyelerinin tek başına veya üçlü test halinde kullanılması tanı koymada yeterli değildir. Bu belirteçler akut karın için nonspesifik belirteçlerdir. Akut apandisitin semptom ve klinik bulgular tanıda önemlidir.

Role of C-reactive protein, procalsitonin and neopterin in the diagnosis of acute appendicitis

Objective: Although the clinical features and the treatment of acute appendicitis has been described negative appendectomies are still high. Several inflammatory parameters are in clinical use but they are not specific. In this study serum C-reactive protein, procalsitonin and neopterin were used to evaluate the role in the diagnosis of acute appendicitis. Materials and Methods: A hundred consecutive patients who admitted to Fırat Üniversity Medical Faculty General Surgery Department with right lower quadrant pain were included to the study. Patients were divided to five groups. Group 1 (n:16):conservative treatment, group 2 (n:6): normal appendix, group 3 (n:38): focal appendicitis, group 4 (n:32): supurative appendicitis, grup 5 (n:8): perforated appendicitis. Serum C-reactive protein, procalsitonin and neopterin were studied at admission. Results: C-reactive protein, procalsitonin and neopterin levels were high in group 3 when compared with group 1 (P<0,05). C-reactive protein and procalsitonin levels in group 4 and 5 were high when compared with group 1(P<0,05) but neopterin did not differ. When compared group 3 and 4 three parameters were not statistically different (P>0,05). Conclusion: In the diagnosis of acute appendicitis C-reactive protein, procalsitonin and neopterin levels have value with the sign and symtomps of the disease. These markers are nonspesific for acute abdomen. Clinical signs ands symtomps are more important for the diagnosis for acute apandicitis.

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