İlyas ERTOK, Dilber KOCAŞABAN ÜÇOZ, Onur KARAKAYALI

Akut Kolesistit-Kolelitiazis Ayırıcı Tanısında Nötrofil/Lenfosit Oranının Klinik Önemi

GİRİŞ ve AMAÇ: Akut kolesistit (AK), acil servise karın ağrısı başvurularının önemli nedenlerinden biridir. Nötrofil sayısındaki artış ve lökosit sayısındaki azalma inflamasyonun fizyolojik bir sonucudur nötrofil lenfosit oranı (NLO) diğer inflamatura markırlar gibi bu süreçte kullanılabilir..Bu çalışmamızda AC tanızında NLO'nın tanısal değeri araştırıldı. GEREÇ ve YÖNTEM: Bu çalışmaya sağ üst kadran ağrısı ile başvuran 318 yetişkin hasta dahil edildi. Bu hastalar 1 Temmuz- 31 Aralık 2013 tarihleri arasında medikal kayıtları olan sağ üst kadran ultrasonografisi yapılan hastalardı. Hastalar AC, kolelitiazis ve patology olmayan grup olmak üzere 3 gruba ayrıldı. Ultrasonografik bulguları ve hastanın tam kan sayımı parametreleri kaydedildi. Grupların NLO skorları hastanın kan parametrelerinden hesaplandı. BULGULAR: Çalışmamızda 382 hasta dosyası incelenmiş olup dışlama kriterlerine uyan 64 hasta çalışma dışı bırakılmıştır. Çalışmaya 318 hasta dahil edilmiştir. Hastaların 221 tanesi (%69,5) kadın, 97 tanesi (%30,5) erkektir. Hastaların 58 tanesinde (% 18,2) akut kolesistit, 70 tanesinde (% 22) kolelitiazis saptanmıştır. 190 hastada (% 59,8) ise her hangi bir patoloji saptanmamıştır.Hastaların yaş ortalaması 47,12±17,30'tir. Akut kolesistit saptanan hastaların yaş ortalaması 55,87±18,48, kolelitiazis saptananan hastaların yaş ortalaması 46,41±16,27, herhangi bir patoloji saptanmayan yaş ortalaması 44,71±16,52'dir Gruplar arasında karşılaştırma yapıldığında NLO'ı akut kolesistit saptanan hastalarda 8,78±6,30, kolelitiazis saptananan hastalarda 2,93±1,69, herhangi bir patoloji saptanmayan hastalarda 3,72±4,02'dir. (p=

Clinical Importance of Neutrophil/Lymphocyte Ratio in Differential Diagnosis of Acute Cholecystitis and Cholelithiasis

INTRODUCTION: Acute cholecystitis (AC) is one of the major causes of abdominal pain in emergency department admissions. Since the number of neutrophils increase and the lymphocytes decrease as a result of a physiological response of circulating leukocytes to inflammation, the neutrophil-tolymphocyte ratio (NLR) can be used as an inflammatory marker with other inflammatory markers. In this study we investigated the diagnostic value of the NLR in the diagnosis of AC METHODS: Included in this study were 318 adults with complaints of right upper quadrant pain. These patients were evaluated with ultrasonography and other data from their medical records between 1 July 2013 and 31 December 2013. The patients were divided into three groups: AC, cholelithiasis, and no pathology. The ultrasonographic findings and complete blood count parameters of the patients were recorded. After the patients were divided into groups, the NLR scores were calculated from patients' blood parameters. RESULTS: A total of 382 patient files were examined and 318 patients were included in the study. Fifty-eight patients (18.2%) had AC, 70 patients (22%) had cholelithiasis, and in 190 patients (59.8%) no pathology was detected. The average NLR scores were 8.78 ± 6.3 in the AC group, 2.93 ± 1.69 in the cholelithiasis group, and 3.72 ± 4.02 in the "no pathology" group (p < 0.001). DISCUSSION AND CONCLUSION: The NLR was significantly higher in AC patients when compared to the other two groups. NLR is a valuable piece of data that can be used with other inflammation markers in the diagnosis of AC

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