İleri derecede immatür bebeklerde trombosit lenfosit oranları (TLO) ile ağır intraventriküler hemoraji (IVH) ilişkisi

Amaç: İntraventriküler hemoraji (IVH), özellikle çok düşük doğum ağırlıklı yeni doğanlarda prematüre doğumların ciddi bir komplikasyonudur. IVH’i tahmin edebilmek oldukça önemlidir. Bu çalışmada 28 hafta altında doğan prematüre bebeklerde doğumda bakılan trombosit lenfosit oranı (TLO) ve intraventriküler hemoraji (IVH) arasındaki ilişki incelenmek istenmiştir. Gereç ve yöntem: Son 5 yılda hastanemizde yatan 28 hafta altı prematüre bebeklerin (n=78) dosyaları geriye dönük incelendi. Doğum sonrası bakılan tam kan verilerinden elde edilen parametreler ve özellikle TLO ve IVH arsındaki ilişki incelendi. Bulgular: Beyaz küre ve lenfosit sayıları ciddi IVH’te (grade 3-4) anlamlı yüksek bulunurken, TLO anlamlı düşük bulunmuştur (sırasıyla 16048±5265 & 11972±10915, p=0,043; 10705±4537 & 6329±8101, p=0,007; 36,9±22,7 & 56,7±37,9 p=0,012). Beyaz küre, lenfosit sayısı ve TLO’nun ciddi IVH’i öngörmede tanısal performansları ROC eğrisi analizleri ile değerlendirildiğinde en güçlü performansın TLO’ya ait olduğu gözlemlendi (sırasıyla eğri altında kalan alan WBC: 0,644; ALS: 0.678; TLO:0,691). TLO kesme değeri 55,84 altındaki değerlerde %94 sensitivite ve %43 spesifite ile ağır IVH’i tahmin ettirebilir. Sonuç: TLO ileri derecede immatur bebeklerde ciddi IVH’i öngörmede değerli bir belirteç olarak kullanılabilir.

Anahtar Kelimeler:

Intraventriküler kanama, Trombosit lenfosit oranı, prematüre

The association between platelet to lymphocyte ratio and intraventicular hemorrhage in extremely immature infants

Aim: Intraventricular hemorrhage (IVH) is a serious complication of premature births, especially in newborns with very low birth weight. It's important to be able to predict IVH. In this study, the relationship between platelet lymphocyte rate (PLR) and intraventricular hemorrhage in premature infants born under 28 weeks was examined. Material and methods: In the last 5 years, the medical records of infants with less than 28 weeks of gestational age (n=78) born in our hospital have been retrospectively examined. Obtained parameters from the whole blood count, especially the relationship between TLO and IVH were examined. Results: White blood cell and lymphocyte counts were significantly higher in severe IVH (grade 3-4), while TLO was found to be significantly lower (16048±5265 & 11972±10915, p=0.043; 10705±4537 & 6329±8101, p=0.007; 36.9±22.7 & 56.7±37.9 p=0.012, respectively). When the white blood cell, lymphocyte count, and PLR's diagnostic performance in predicting severe IVH were evaluated by ROC curve analyses, it was observed that the strongest performance belonged to the PLR (Area under the curve, AUC for WBC: 0.644; ALS: 0.687; PLR:0,691, respectively). PLR can estimate severe IVH with 94% sensitivity and 43% specificity at a cut-off value below 55.84. Conclusion: PLR can be used as a valuable marker for predicting IVH in extremely premature infants.

Keywords:

platelet to lymphocyte ratio, intraventicular hemorrhage, premature,

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