Yenidoğan sepsisi tanısında enfeksiyon markeri olarak granülosit koloni stimülan faktör'ün önemi

Bu çalışmada, granulosit koloni sitimulan faktör (G-CSF)'ün yenidoğan sepsisindeki tanı değeri ve diğer parametrelerle postnatal yaş, lökosit (WBC), immatür/total nötrofil (I/T) oranı, trombosit, mikrosedimentasyon (mikrosedim), C-reaktif protein (CRP), vücut ısısı ilişkisi araştırıldı. Çalışmaya, kan kültürü pozitif olan sepsisli, miadında doğmuş 30 yenidoğan hasta alındı. Kontrol grubu olarak da sağlıklı, miadında doğmuş 30 yenidoğan alındı. Gruplar arasında; postnatal yaş ve vücut ısısı yönünden herhangi bir fark bulunamazken (p0.05), WBC (p0.05), I/T oranı, trombosit, mikrosedim, CRP ve G-CSF yönünden önemli derecede fark bulundu (p0.001). Parametreler arasındaki ilişkiye bakıldığında, kontrol grubunda G-CSF ile diğer parametreler arasında anlamlı bir ilişki bulunamadı. Hasta grubunda ise, G-CSF ile postnatal yaş, WBC, CRP ve vücut ısısı arasında herhangi bir ilişki bulunmamasına karşın, G-CSF ile I/T oranı ve mikrosedimentasyon arasında pozitif bir ilişki bulundu. Ayrıca G-CSF ile trombosit sayısı arasında sınırda negatif bir ilişki bulundu. Sonuç olarak G-CSF'in yenidoğan sepsisi tanısında yararlı bir marker olabileceği söylenebilir.

Importance of granulocyte colony-stimulating factor as a infection marker in diagnosis of newborn sepsis

In this study, the diagnostic value of granulocyte colony-stimulating factor (G-CSF) in newborn sepsis and its relationship with other parameters postnatal age, leukocyte (WBC), immature/total neutrophil (I/T) ratio, platelet count, microsedimentation, C-reactive protein (CRP) and body temperature were investigated. Thirty term babies with blood culture positive sepsis were included in this study. Thirty healthy term babies were taken as the control group. Between the groups, while there was not any significant difference in postnatal age and body temperature (p0.05), significant differences were determined with respect to WBC (p0.05), I/T ratio, platelet count, microsedimentation, CRP and G-CSF (p0.001). In correlation analysis, no significant correlation was found between G-CSF and other parameters in the control group. In the patient group, no significant correlation was seen between G-CSF with postnatal age, WBC, CRP and body temperature. However, G-CSF was correlated positively with I/T ratio and microsedimentation. Additionaly, there was a borderline negative correlation between G-CSF and platelet count. As a conclusion, it can be stated that G-CSF may be a useful marker in the diagnosis of newborn sepsis.

Kaynakça

1. Kennon C, Overturf G, Bessman S, Sierra E, Smith KJ, Brann B. Granulocyte colony- stimulating factor as a marker for bacterial infection in neonates. JPediatr 128:765-769, 1996. 2. Berner R, Niemeyer CM, Leititis JU, et al. Plasma levels and gene expression of granulocyte colony-stimulating factor, tumor necrosis factor-a, interleukin (IL)-lp, IL-6, IL-8, and soluble intercellular adhesion molecule-1 in neonatal early onset sepsis. Pediatr Res 44:469-477, 1998. 3. Presneill JJ, Waring PM, Layton JE, et al. Plasma granulocyte colony-stimulating factor and granulocyte-macrophage colony- stimulating factor levels in critical illness including sepsis and septic shock: Relation to disease severity, multiple organ dysfunction, and mortality. Crit Care Med 28:2344-2354, 2000. 4. Shimada M, Minato M, Takada M, Takahashi S, Harada K. Plasma concentration of '. granulocyte-colony-stimulating factor in - neonates. Ada Pediatr 85:351-355, 1996.

5. Chirico G, dardelli L, Cecchi P, De AmiciM, Gasparoni A, Rondini G. Serum concentration of granaulocyte colony stimulating factor in term and preterm infants. Eur J Pediatr 156:269-271, 1997. 6. Gessler P, Kirchmann N, Kientsch-Engel R, Hass N, Lasch P, Kachel W. Serum concentrations of granulocyte colony- stimulating factor in healthy term and preterm neonates and in those with various diseases including bacterial infections. Blood 82(10):3177-3182, 1993. 7. Kawakami MT, Tsutsumi H, Kumakawa T, et al. Levels of serum granulocyte colony- stimulating factor in patients with infections. Blood 76(10): 1962-1964, 1990. 8. Lower J, Duncan E, Abboud M, et al. High levels of granulocyte and granulocyte- macrophage colony-stimulating factors in cord blood of noi-mal full-term neonates. J Pediatr 116:627-632, 1990. 9. Zipursky A, Palko J, Milner R, Akenuza G. The hematology of bacterial infection in premature infants. Pediatrics 57:839-853, 1976. lO.Hayden WR. Sepsis terminology in pediatrics. J Pediatr 124:657-658, 1994. 11. Regan JA, Klebonoff MA, Nugent RP, et al. Colonization with group B streptococci in pregnancy and adverse outcome. Am J Obstet GynecoU74:1357-1360, 1996. U.Küçüködük S, Öğen Ü, Dinç H, Barış YS, Gürses M. Yenidoğan sepsisinde trombosit parametreleri. OMU Tıp Dergisi 8:329-337, 1991. 13. Gomella TL, Cunningham MD, Eyol FG. Neonatology: Management, Procedures, On - call problems disease and drugs 3rd ed, pp.3 39- 343, 1994. 14. Remington JS, Klein JO. Bacterial sepsis and meningitis. Chap. 18, P. 601 In: Infectious disease of the fetus and newborn infant 3rd ed. Sounders, pp. 601-644, 1990. 15. Peter G, Cashore WJ. Infectious diseases of the fetus and newborn infant 3rd ed. pp. 1000- 10İ9, 1990. 16. Mg PC, Cehng SH, Chui KM, et al. Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birth weight infants. Arch Dis Child 77:221-227, 1997. 17. Mutlu M, Aslan Y. Neonatal periyod içindeki sağlıklı prematür ve matür yenidoğanlarda C- reaktif pretein, haptoglobulin ve alfa-1 asit glikopretein seviyelerinin normal değerleri. İbniSina Tıp Dergisi 6:146-150, 2001.

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