Alpay MEDETALİBEYOĞLU, Seda ÇELİK, Rabia DENİZ, Emine Bilge ÇAPARİLİ, Murat KÖSE, Timur Selçuk AKPINAR, Yücel ARMAN, Adem ATICI, Murat AKARSU, Şengül AYDIN YOLDEMİR, İ̇brahim Hakkı KÖKER, Tufan TÜKEK

SPONTAN BAKTERİYEL PERİTONİTİN TANISINDA STREM-1 MOLEKÜLÜNÜN TANISAL DEĞERİ

Amaç: Bu çalışmanın amacı portal tipte asidi olan hastalarda sTREM-1 molekülünün spontan bakteriyel peritonit tanısındaki rolünü araştırmaktır. Gereç ve Yöntem: Çalışmaya portal tipte asiti olan 122 hasta dahil edildi, 58 hastada enfekte asit (K/E:27/31, ortalama yaş 61,6±15,0 yıl), 64 hastada enfekte olmayan asit (K/A:23/41, ortalama yaş 63,4±9,4) vardı. Hastalardan başvuru sırasında alınan kan örneklerinde tam kan sayımı, albümin ve C-reaktif protein (CRP) değerleri; eşzamanlı alınan periton sıvısı örneklerinde ise albümin, total protein, laktat dehidrojenaz, (LDH) ve sTREM-1 seviyeleri ölçüldü. Bulgular: Enfekte asitli ve enfekte olmayan asitli hastalar karşılaştırıldığında asit nötrofil, serum nötrofil, CRP, asit LDH ve asit sTREM-1 düzeylerinde anlamlı farklılıklar görüldü. Asit nötrofil, serum nötrofil, CRP ve sTREM-1 için eğrinin altında kalan alanlar (EAA) sırasıyla 1,0 (%95 CI 1,0-1,0), 0,676 (%95 CI 0,580-0,771), 0,721 (%95 CI 0,632-0,811) ve 0,644 (%95 CI 0,546-0,74) idi. Ayrıca kadın hastalarda sTREM-1 değerleri; asit nötrofil, asit LDH, asit albümin, asit total protein değerleri ve trombosit sayısı ile pozitif korelasyon gösterdi. Sonuç: Asit enfeksiyonu portal hipertansiyonun önemli bir komplikasyonudur ve geleneksel tanı metodu asit nötrofil sayısı ölçümüdür. sTREM-1, özellikle nötrofil sayısında artış olmayan peritonit vakalarında, asit enfeksiyonlarını tanımlamak için alternatif bir belirteç olabilir.

Anahtar Kelimeler:

sTREM-1, spontan bakteriyel peritonit, asit

DIAGNOSTIC VALUE OF SOLUBLE TRIGGERING RECEPTOR EXPRESSED ON MYELOID CELLS IN SPONTANEOUS BACTERIAL PERITONITIS

Objective: The aim of this study is to investigate the role of sTREM-1 molecule in the diagnosis of spontaneous bacterial peritonitis in patients with portal type ascites. Material and Method: We included 122 patients with portal type ascites in the study, 58 had infected ascites (peritonitis) (F/M:27/31, mean age 61.6±15.0 years) and 64 had uninfected ascites (F/M:23/41, mean age 63.4±9.4). Complete blood count, albumin, and C-reactive protein (CRP) were defined in the blood samples. Additionally, neutrophil count, albumin, total protein, lactate dehydrogenase (LDH), and sTREM-1 levels were measured in the peritoneal fluid samples. Results: There were significant differences in ascites neutrophil, serum neutrophil, CRP, ascites LDH, and ascites sTREM-1 levels between two groups. AUC values for ascites neutrophil, serum neutrophil, CRP, and sTREM-1 were 1.0 (95% CI 1.0-1.0), 0.676 (95% CI 0.580-0.771), 0.721 (95% CI 0.632-0.811), and 0.644 (95% CI 0.546-0.74), respectively. In females, sTREM-1 levels were positively correlated with ascites neutrophil, ascites LDH, ascites albumin, ascites total protein levels, and platelet count. Conclusion: Infection of ascites is an important complication of portal hypertension and ascites neutrophil count measurement is the traditional method used for diagnosis. sTREM-1 can be an alternative marker to identify ascites infections, especially in the cases of peritonitis without an increase in neutrophil count.

Keywords:

sTREM-1, spontaneous bacterial peritonitis, ascites,

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