Ceren ŞEN TANRİKULU, Hilal HOCAGİL, Emine GENCER, Ercan GENCER, A. Cüneyt HOCAGİL

Nefes Darlığı ile Acil Servise Başvuran Hastalarda s-TREM’in Konjestif Kalp Yetmezliği ve Pnömoni Ayrımındaki Rolü

Amaç: Konjestif kalp yetmezliği (KKY) ve pnömoni acil servise nefes darlığı ile başvuran hastalarda en önemli potansiyel ölüm nedenleridir. Hem KKY hem de pnömonide erken tanı ve uygun müdahale hayat kurtarıcıdır. Bu çalışmanın amacı, pnömoninin CHF’den ayırıcı tanısında inflamatuar bir biyobelirteç olan miyeloid hücreler-1 üzerinde eksprese olan çözünür tetikleyici reseptörün (sTREM-1) tanısal yeteneğini araştırmaktır. Materyal ve Metot: Bu prospektif çalışma, 1 Haziran 2014 – 30 Mayıs 2015 tarihleri arasında devlet hastanesi ve üniversite hastanelerinin acil tıp bölümlerinde gerçekleştirildi. Dispne ile başvuran hastalar uluslararası kılavuzlara göre yapılan tanılara göre değerlendirildi ve iki gruba ayrıldı; CHF grubu ve pnömoni grubu. Gruplar klinik ve demografik özellikler ve sTREM-1 düzeyleri açısından karşılaştırıldı. Bulgular: Her grupta 15 hasta değerlendirildi. KKY grubunda nabız hızı daha yüksek iken (p<0,001), pnömoni grubunda solunum hızı ve sıcaklık değerleri daha yüksekti (p=0,002, p=0,008). Akciğer grafilerinde pnömoni grubunda anlamlı infiltrasyon, KKY grubunda kardiyomegali gözlendi (p<0,001). STREM-1 düzeyleri, pnömoni grubunda, CHF grubundan daha yüksekti ve aradaki fark istatistiksel olarak anlamlıydı (p=0,044). Sonuç: Biz STEM’in acil serviste dispnenin ayırıcı tanısında kuulanılabileceğini, ancak daha kapsamlı çalışmalarla bunun desteklenmesi gerektiğini düşünüyoruz.

Anahtar Kelimeler:

kronik kalp yetmezliği, pnömoni, sepsis, sTREM-1

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