Burcu KISA KARAKAYA, Hatice ÇELİK KANSU, Mehmet KEÇECİOĞLU, Özlem EVLİYAOĞLU

Trombosit parametreleri pelvik inflamatuar hastalıkta belirteç olarak kullanılabilir mi?

Amaç: Çalışmamızın amacı, bizim kliniğimizde tedavi edilmiş, tubaovarian abseli TOA , piyosalpenksli ve komplike olmayan pelvik inflamatuar hastalıklı PİD olguların platelet parametreleri açısından karşılaştırılmasıdır. Metod: Bu çalışmaya, Ocak 2011 ile Aralık 2016 tarihleri arasında bizim jinekoloji kliniğinde yatarak tedavi gören pelvik inflamatuar hastalıkla PİD uyumlu 104 hasta dâhil edildi. TOAlı 31, piyosalpenksli 25 ve kontrol grubu olarak komplike olmamış 49 PİD olgusu retrospektif olarak değerlendirildi. Çalışmamızda her üç gruptaki olgular yaş, gravida, parite, başvuru şikayetleri, rahim içi araç RİA kullanım oranı, ultrason bulguları, operasyon bulguları, lökosit sayımı, trombosit sayımı, MPV Mean Platelet Volume , PDW Platelet Distribution Width ve PCT Platelet Crit değerleri açısından karşılaştırıldı. Bulgular: Her üç grup arasında yaş ve obstetrik öyküleri bakımından istatistiksel fark saptanmadı. RİA kullanımı TOA lı hasta grubunda diğer iki gruba göre anlamlı olarak daha yüksek bulundu. Lökosit sayısı ve CRP düzeyleri TOA lı grupta diğer iki gruba göre anlamlı olarak yüksek bulundu. CA125 düzeyleri komplike olmayan PİD grubunda TOA ve piyosalpenks grubuna göre anlamlı olarak daha düşük bulundu. Trombosit sayısı TOAlı grupta komplike olmayan PİD grubuna göre anlamlı olarak daha yüksek bulundu. MPV, PCT, PDW değerleri açısından her üç grupta istatistiksel fark saptanmadı. TOA lı ve piyosalpenksli hastaların hastanede kalış süreleri komplike olmayan PİD grubuna göre daha uzun olarak bulundu. Sonuç: PİD li hastalarda lökositoz ve trombositoz TOA ya ilerlemede bir belirteç olarak kullanılabilir.

Anahtar Kelimeler:

Pelvik inflamatuar hastalık, tubaovarian abse, piyosalpenks, trombosit

Can platelet parameters be used as the indicator in pelvic inflammatory diseases?

Aim: The objective of our study is to compare platelet parameters in tubo-ovarian abscess TOA , pyosalpinx, and uncomplicated pelvic inflammatory disease PID cases treated in our clinic. Methods: Total 104 patients of PID who were hospitalized in our gynecology clinic between January 2011 and December 2016, were included in this study. 31 patients with TOA, 25 patients with pyosalpinx, and as control group, 49 uncomplicated PID cases were evaluated retrospectively. Groups were compared in terms of age, gravidity, parity, complaints, intrauterine device IUD usage, ultrasound findings, operative findings, leukocyte count, platelet count, MPV Mean Platelet Volume , PDW Platelet Distribution Width , and PCT Platelet Crit values. Results: There was no statistically significant difference in age and obstetric history between the three groups. The use of IUD was significantly higher in the TOA group compared to the other two groups. The Ca125 levels were significantly lower in the uncomplicated PID group than in the TOA and the pyosalpinx group. The platelet count was significantly higher in the TOA group than in the uncomplicated PID group. Comparing the MPV, PCT, and PDW values, there was no statistically significant difference between the three groups in terms of hospitalization period. Patients with TOA and pyosalpinx were observed to have longer hospitalization times than uncomplicated PID group. Conclusion: In patients with PID, leukocytosis and thrombocytosis can be an indicator of progression to TOA.

Keywords:

Pelvic inflammatory disease, tubo-ovarian abscess, piyosalpinx, thrombocyte,

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1. Grodstein F, Rothman KJ. Epidemiology of pelvic inflammatory disease. Epidemiology 1994;5:234- 242.
2. Mitchell C, Prabhu M. Pelvic inflammatory: current concepts in pathogenesis, diagnosis and treatment. Infect Dis Clin North Am 2013;27:793-809.
3. Beyazıt Y, Sayilir A, Torun S, et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012;36:162-168.
4. Seker A, Incebiyik A, Kucuk A, et al. Mean platelet volume in patients with acute and chronic cholecystitis. Acta Med Mediter 2013;29:515-519.
5. Incebıyık A. Seker A. Vural M. et al. May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease? Wien Klin Wochenschr 2014;126:422-426.
6. De Cherney AH, Nathan L, Sexually Transmitted Disseas Pelvic Infections. In; Aibinder SW, Ramin SM. Current Obstetrics Gynecologic diagnosis And Treatment, Ninth edition 2003;716-750.
7. Kielly M, Jamieson MA. Pelvic inflammatory disease in virginal adolescent females without tubo-ovarian abscess. J Pediatr Adolesc Gynecl.2014;27:e5-7.
8. Peipert JF, Boardman L, Hogan JW. Et al. Labaratory evaluation of acute upper genital tract infection. Obstet Gynecol 1996;87:730-736.
9. Yohannan MD, Higgy KE, al-Mashhadani SA. et al. Trombocytosis. Etiologic analysis of 663 patients. Phila1994;33:340-343.
10. Klinger MH, Jelkman W. Role of blood platelets in infection and inflammation. J Interferon Cytokine Res 2002; 22:913-922.
11. Ishiguro A, SuzukiY, Mito et al. Elevation of serum trombopoetin precedes thrombocytosis in acute infections. Br J Haematol 2002;116:612-618.
12. Karaman H, Karakukcu C, Kocer D. Can mean platelet volume serve as a marker for prostatitis? Int J Med Sci.2013; 10:1387-1391.
13. Gasparyan AY, Ayvazyan L, et al, Mean platelet volume:a link between thrombosis and inflammation? Curr Pharm Des 2011;17:47-58.
14. Vincent K. Pelvic pain in women: clinical and scientific aspects. Current Opinion in supportive and Palliative Care 2011;5;143-149.