Nermin DİNDAR BADEM, Seydi Ali PEKER, Sedat KAYGUSUZ

EŞ ZAMANLI PCT VE CRP İSTENEN TOPLUM KÖKENLİ PNÖMONİ VE KOAH ALEVLENMESİ OLAN HASTALARDA BU PARAMETRELERİN KORELASYONU VE MALİYET ETKİLİLİK AÇISINDAN DEĞERLENDİRİLMESİ

Amaç: Bakteriyel enfeksiyonlar önemli morbidite ve mortalite nedenidir. Serum prokalsitonin ve C-reaktif protein sistemik inflamasyon ve bakteriyel enfeksiyonların tanı, tedavi ve takibinde önemli belirteçlerdir. Bu çalışmada nihai tanıları pnömoni ve/veya KOAH alevlenmesi olan hastalarda son zamanlarda enfeksiyon takibinde sıklıkla kullanılmaya başlanan prokalsitonin ile klasik belirteç olarak kullanılan C-reaktif protein düzeyleri arasındaki korelasyon araştırıldı. Ayrıca alt solunum yolu enfeksiyonu tanısı ya da yönetimi için C-reaktif proteinin mi, prokalsitoninin mi maliyet etkililik açısından yararlı olduğunu saptamayı amaçladık.Gereç ve Yöntemler: Toplam 1948 hastadan elde edilmiş 4712 örnekten eş zamanlı çalışılan prokalsitonin ve C-reaktif protein sonuçları değerlendirildi. Örneklerden 499’u (%10.6) KOAH alevlenmesi (Grup I), 1480’i (%31.4) pnömoni (Grup II) ve 2733 (%58)’i KOAH alevlenmesi ve pnömoni (Grup III) tanısı almış hastaların örneklerinden oluşuyordu.Bulgular: C-reaktif protein ve prokalsitonin düzeyleri arasında pozitif güçlü korelasyon saptandı (rho=0.512, p<0.001). Yine prokalsitonin ve C-reaktif protein arasındaki grup içi değerlendirmede Grup I, Grup II ve Grup III’de pozitif güçlü korelasyon tespit edildi (sırasıyla rho=0.539, p<0.001; rho=0.509, p<0.001; rho=0.511, p<0.001).Sonuç: Prokalsitoninin C-reaktif protein ile korelasyon gösterdiği, enfeksiyonun ileri dönem takibinde yüksek maliyetli prokalsitonin yerine C-reaktif protein ölçümünün kullanılmasının uygun olacağı kanaatine varılmıştır.

Anahtar Kelimeler:

KOAH alevlenmesi, Toplum kökenli pnömoni, prokalsitonin, C-reaktif protein

Correlation and Assessment of Cost-Effectivity of Simultaneous PCT and CRP Measurements for Patients with Community-Acquired Pneumonia and COPD Inflamation

Objective: Bacterial infections are important causes of morbidity and mortality. Serum procalcitonin and C-reactive protein are significant indicators during the diagnosis, treatment and follow-up of systemic inflammations and bacterial infections. In this study, correlation between levels of procalcitonin, which has recently become commonly used in infection cases, and C-reactive protein, the conventional indicator, were investigated for patients whose final diagnoses were found as pneumonia and/or COPD inflammation. Additionally, the study aimed to determine which among the two indicators was cost-effective for the diagnosis and management of lower respiratory infections.Material and Methods: Procalcitonin and C-reactive protein results of 4712 samples, which were gathered from 1948 patients and measured simultaneously were assessed. Among the samples, 499 (10.6%) were from COPD inflammation patients (Group I), 1480 (31.4%) were from pneumonia patients (Group II), and the remaining 2733 (58%) were from COPD inflammation and pneumonia patients (Group III).Results: A strong positive correlation was detected between C-reactive protein and procalcitonin levels (rho=0.512, p<0.001). As for the assessments within the established groups I, II and III, again a strong positive correlation was seen (rho=0.539, p<0.001; rho=0.509, p<0.001; rho=0.511, p<0.001, respectively).Conclusion: Procalcitonine was found to be positively correlated to C-reactive protein and it was suggested that procalcitonine could be used instead of the costly C reactive protein during long-term infection care.

Keywords:

Community-acquired pneumonia, COPD inflammation, procalcitonin, C-reactive protein,

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