Ergün ALMA, Hakan ERÇİL, Adem ALTUNKOL, Güçlü GÜRLEN, Ediz VURUŞKAN, Onur KÜÇÜKTOPÇU, Zafer Gökhan GÜRBÜZ

Üriner Sistem Enfeksiyonu Olan Gebelerde Nötrofil Lenfosit Oranının Tedaviye Dirençli Hastaları Tahmin Etmede ve Tedavinin Takibindeki Rolü

Giriş: Üriner sistem enfeksiyonu(ÜSE) olan gebelerde nötrofil lenfosit oranının(NLO) tedaviye direnç ve takipteki rolünü değerlendirmek. Gereç ve Yöntemler: Eylül2016-Aralık 2018 tarihleri arasında ÜSE şikayetleri ile başvuran 88 gebenin kayıtları retrospektif olarak incelendi. Etyolojiyi daha da komplike hale getiren taş hastalığı, JJ stent ya da nefrostomi yerleştirilmesi, üriner sistem anatomik malformasyonu olan hastalar çalışmadan dışlandı. Hastalar ilk ve üçüncü günkü medikal tedavisine göre iki gruba ayrılarak değerlendirildi. Bulgular: Grup A’ da yaş ortalaması 23.7±4.7 olan 64 hasta ve grup B’ de24.4±6.0 olan 24 hastadan oluşmaktaydı. İlk başvuruda NLR ortalaması grup’ A da 4.7+1.2 ve grup’ B de 7.1+1.9 idi. Grup’ B de ampirik tedavi sonrası 3. günde bu değer 6,7±2,1 idi ve aradaki farklılık istatistiksel olarak anlamlı değildi(P >0.05). Tedavi süreci sonunda grup’ A da NLR ortalaması 2.4+1.0’a gerilerken, grup’ B de ise 1.4+0.6 düzeyine gerilemişti(P<0.05). NLR için cutoff değeri 6.15 olarak belirlendi(Sensitivite 0.76, spesifite 0.86 ve P <0,001). NLO için cutoff değeri 6.15 olarak belirlendi(sensitivite 0.76, spesifite 0.86 ve p<0,001). Tüm hastalar bu cutoff değerine göre tekrar karşılaştırıldığında ilk başvuruda grup A’ da 9(%14) ve grup’ B de19 (%79.1) hasta bu değerin üzerinde NLO seviyesine sahipti(P<0.001). Sonuç: NLO hem tedaviye dirençli hasta grubunun belirlenmesinde hem de tedaviye yanıtın izlenmesinde klinisyene yararlı olabilecek bir belirteçtir.

Anahtar Kelimeler:

üriner sistem enfeksiyonu, lenfosit nötrofil oranı, gebe

The Role of Neutrophil-lymphocyte Rate in Treatment Resistant Patients in Treatments With Urinary Tract Infection

Objective: To evaluate the role of neutrophil-lymphocyte ratio in treatment resistance and follow-up in pregnant women with lower urinary tract infection.Materials and methods: The data of 88 pregnant women with UTI complaints between September 2016 and December 2018 were retrospectively reviewed. Patients with stone disease, JJ stent or nephrostomy placement, and urinary system anatomic malformation that complicate the etiology were excluded from the study. Patients were divided into two groups according to their first and third day medical treatment.Results: Group A consisted of 64 patients with a mean age of 23.7 ± 4.7 years and group B consisted of 24 patients with 24.4 ± 6.0 years. The mean NLR at the first visit was 4.7 + 1.2 in group A and 7.1 + 1.9 in group B. In group B, this value was 6.7 ± 2.1 on the third day after empirical treatment and the difference was not statistically significant (p> 0.05). At the end of the treatment period, the mean NLR in group A decreased to 2.4 + 1.0, and it decreased to 1.4 + 0.6 in group B(P <0.05). The cutoff value for NLR was 6.15 (sensitivity 0.76, specificity 0.86, and P <0.001). When all patients were compared according to this cutoff value, 9 (14%) and 19 (79.1%) patients in group A had NLR levels above this value at the first admission (P <0.001). Conclusion: NLR is a marker that can be useful to the clinician both in determining the treatment-resistant patient group and in following the response to treatment.

Keywords:

Urinary tract infection, Neutrophil-lymphocyte ratio, Pregnant,

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