Serum Albumin Düzeyleri ile Akut Pulmoner Emboli Klinik Formları Arasındaki İlişki

Amaç: Bu çalışmanın amacı, akut pulmoner emboli (PE) hastalarında albumin düzeylerindeki değişiklikleri araştırmak ve klinik formlarında ki tanı değerini değerlendirmektir. Gereç ve Yöntem: Göğüs Hastalıkları Kliniğine başvuran ve PE tanısı konan toplam 110 olgu retrospektif olarak çalışmaya dahil edildi. PE hastaları klinik formlarına göre 28 masif 33 submasif ve 49 masif olmayan olmak üzere üç gruba ayrıldı. Serum albumin, CRP, D-dimer düzeyleri ve diğer parametrelerde ki farklılıklar üç grup arasında analiz edildi. Bulgular: Serum albumin düzeyleri, masif grupta, submasif ve nonmassif gruba göre istatistiksel olarak daha düşük bulundu (sırasıyla, p =0.003 ve p =0.001). CRP düzeyleri massif grupta non masif gruba göre istatistiksel olarak yüksek bulundu p =0.027. Sağ ventrikül çapı ile albumin arasında negatif korelasyon olduğu belirlendi (r =-0.26, p =0.005). Masif emboliyi öngörmede ROC analizi ile albumin kesme değeri ≤3,35 olarak alındığında, albumin duyarlılığı %79 ve özgüllüğü %70 (AUC = 0.75,% 95 CI = 0.64-0.85, p =0,001) olarak bulundu. Sonuç: Bir negatif akut faz reaktanı olan albuminin masif PE’de ki düşük seviyeleri artmış bir inflamatuar durumu yansıyor olabilir. Ayrıca düşük albumin düzeyleri akut pulmoner embolinin şiddetini göstermede bir indikatör olabilir.

The Relationship Between Serum Albumin Levels and Clinical Forms of Acute Pulmonary Embolism

Objective: The aim of this study is to investigate the changes in albumin levels in patients with acute pulmonary embolism (PE) and to evaluate the diagnostic value in clinical forms of PE. Material and Method: One hundred ten patients who applied to Chest Diseases Clinic and were diagnosed with PE were included in the study ret-rospectively. PE patients were divided into three groups as 28 massive, 33 submassive and 49 nonmassive, according to the clinical form. Differences in serum albumin, CRP and D-dimer results and other markers were analyzed among the three groups. Results: Serum albumin levels were found to be statistically lower in the massive group compared to the submassive and nonmassive groups (p =0.003 and p =0.001, respectively). CRP levels were statistically higher in the massive group than the non-massive group p =0.027. There was a negative correlation between right ventricular diameter (RVD) and serum albumin levels (r =-0.26, p =0.005). When albumin cut-off value was taken as ≤3.35 to predict massive embolism by ROC analysis, albumin sensitivity was found to be 79% and specificity to be 70% (AUC = 0.75, 95% CI = 0.64-0.85, p =0.001). Conclusion: Albumin is known as a negative acute phase reactant and its lower levels in massive PE may reflect an increased inflammatory state. Also, low albumin levels can be an indicator of the severity of acute pulmonary embolism.

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