Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki

Attila Önmez; Ece Bilir; Serkan Torun

doi:10.18521/ktd.492274

Research Article

Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki

Year 2019, Volume: 11 Issue: 1, 24 - 29, 25.03.2019

Attila Önmez Ece Bilir Serkan Torun

https://doi.org/10.18521/ktd.492274

Cited By: 5

Abstract

Amaç: Bu çalışmada sistemik inflamasyon ile ilişkili bir marker olduğu gösterilen; Nötrofillenfosit oranı (NLR), platelet-lenfosit oranı (PLR), ortalama trombosit hacmi (MPV) ve Eritrosit dağılım hacmi (RDW) ile akut pankreatitin (AP) başvuru anındaki ciddiyetini gösteren Ranson kriteri ile aralarındaki ilişkinin gösterilmesi amaçlanmıştır.
Gereç ve Yöntem: Ocak 2017 ile Kasım 2018 tarihleri arasında AP tanısı ile takip eden hastaların verilerine retrospektif olarak ulaşıldı. 82 biliyer ve 15 nonbiliyer olmak üzere toplam 139 hasta çalışmaya alındı. Hastaların ilk başvuru anında bakılan hemogram ve biyokimyasal parametreleri, yaşları, cinsiyetleri, ko-morbiditeleri ve yatış süreleri kaydedildi. İlk başvuru anında bakılan Ranson Kriterlerine göre skoru < 3 ve skoru ≥ 3 pozitif olanlar olmak üzere 2 gruba ayrıldı ve bu gruplar karşılaştırıldı.
Bulgular: AP tanısı ile takip edilen 139 hastanın 75 (%54)’i erkek, 64 (%46)’ü kadındı. Hastaların 113’ü Ranson kriterlerine göre 3’ün altında 26’sı ise 3 ve üzerindeydi. Ortalama yaş hafif AP grubunda 61±20 yıl, şiddetli AP grubunda ise 70±13 yıldı. MPV (P< 0.001) ve NLR (P< 0.001) değerleri gruplar arasında anlamlı olarak farklı saptandı. Korelasyon analizinde; NLR ile ranson skoru arasında pozitif korelasyon saptandı (r= 0,253 p<0,01). Yapılan Lineer Regresyon analizi sonucunda, NLR ve PLR’nin AP şiddetini göstermede bağımsız prediktör oldukları bulundu.
Sonuç: Sistemik inflamasyonu gösteren çalıştığımız parametrelerden NLR, AP’nin şiddetini belirlemede basit ve güvenilir bir gösterge olarak kullanılabilir

Keywords

Akut Pankreatit, Ranson Kriteri, Pankreatit Ciddiyeti, Nötrofil-Lenfosit Oranı, Trombosit-Lenfosit Oranı, Ortalama Trombosit Hacmi

References

1. Balthazar EJ. CT diagnosis and staging of acute pancreatitis. Radiol Clin North Am 1989;27:19–37
2. Lerch MM, Adler G. Experimental animal models of acute pancreatitis. Int J Pancreatol 1994;15:159–70.
3. Suppiah A, Malde D, Arab T, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acutepancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17:675-81.
4. Xu ZS, Zhang FP, Zhang Y, et al.Prognostic role of the pre-treatment platelet-lymphocyte ratio in pancreatic cancer: A meta-analysis. Oncotarget 2017; 8: 99003-99012
5. Sandhaus LM, Meyer P. How useful are CBC and reticulocyte reports to clinicians? Am J Clin Pathol 2002;118: 787—93.
6. Gasparyan AY, Stavropoulos-Kalinoglou A, Toms TE, et al. Association of mean platelet volume with hypertension in rheumatoid arthritis. Inflamm Allergy Drug Targets 2010;9:45—50
7. Feng P, He C, Liao G, et al. Early enteral nutrition versus delayed enteral nutrition in acute pancreatitis: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2017; 96: e8648.
8. Yang Z, Dong L, Zhang Y, et al. Prediction of severe acute pancreatitis using a decisiontree model based on the revised atlanta classification of acute pancreatitis. PLoSOne 2015; 10: e0143486.
9. Ignatavicius P, Gulla A, Cernauskis K, et al. How severe is moderately severe acute pancreatitis? Clinical validation of revised 2012 Atlanta Classification. World J Gastroenterol 2017; 23: 7785-7790.
10. Ferreira Ade F, Bartelega JA, Urbano HC, et al. Acute pancreatitis gravity predictive factors: which and when to use them? Arq Bras Cir Dig. 2015 Jul-Sep;28(3):207-11
11. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis
12. M. England and M. C. Down, "Red-Cell-Volume Dıstrıbutıon Curves And The Measurement Of Anısocytosıs," The Lancet, vol. 303, no. 7860, pp. 701-703, 1974
13. K. Şenol, B. Saylam, F. Kocaay, et al. "Red cell distribution width as a predictor of mortality in acute pancreatitis," (in eng), Am J Emerg Med, vol. 31, no. 4, pp. 687-9, Apr 2013.
14. D. Wang. "Red cell distribution width predicts deaths in patients with acute pancreatitis," (in eng), J Res Med Sci, vol. 20, no. 5, pp. 424-8, May 2015
15. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96:776—81.
Jaremo P, Lindahl TL, Lennmark C, et al. The use of platelet density and volume measurements to estimatethe severity of preeclampsia. Eur J Clin Invest 2000;30: 1113—38.
17. Choi CU, Seo HS, Kim YK, et al. Can mean platelet volumepredict coronary vasospasm? Platelets 2011;22:173—8
18. Beyazit 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 Apr;36(2):162-8.
19. Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperativeneutrophil-lymphocyte ratio andoutcome from coronary artery bypass grafting.Am Heart J 2007; 154: 995–1002.
20. Suppiah A, Malde D, Arab T, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17(4): 675–81
21. Azab B, Jaglall N, Atallah JP. et al. Neutrophil-Lymphocyte Ratio as a Predictor of Adverse Outcomes of Acute Pancreatitis. Pancreatology. 2011;11(4):445-52.

The Relationship Between Acute Pancreatitis Severity of Platelet Lymphocyte Ratio, Neutrophil Lymphocyte Ratio, Erythrocyte Distribution Width and Mean Platelet Volume

Year 2019, Volume: 11 Issue: 1, 24 - 29, 25.03.2019

Attila Önmez Ece Bilir Serkan Torun

https://doi.org/10.18521/ktd.492274

Cited By: 5

Abstract

Objective: In this study we have shown that there is a marker associated with systemic inflammation; The aim of this study was to determine the relationship between neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), mean platelet volume (MPV) and Erythrocyte distribution volume (RDW) and Ranson Criteria showing the severity of acute pancreatitis (AP) at the time of presentation.
Methods: The data of the patients who were diagnosed with AP between January 2017 and November 2018 were retrospectively obtained. A total of 139 patients (82 biliary and 15 nonbiliary) were included in the study. Hemogram and biochemical parameters, age, gender, co-morbidities and duration of hospitalization were recorded. According to the Ranson Criteria used at the time of admission score < 3 and score ≥ 3 positive and these groups were compared.
Results: Of the 139 patients diagnosed with AP, 75 (54%) were male and 64 (46%) were female. 113 of the patients were divided into two groups according to the Ranson criteria. The mean age was 61 ±20 years in the mild AP group and 70 ±13 years in the severe AP group. MPV (P <0.001), NLR (P <0.001) values were significantly different between the groups. In the correlation analysis; there was a positive correlation between NLR and ranson score (r = 0.253 p <0.01). Linear regression analysis showed that, NLR and PLR were independent predictors of acute pancreatitis.
Conclusion: NLR can be used as a simple and reliable indicator in determining the severity of AP.

Keywords

Acute Pancreatitis, Ranson Criteria, Severity of Pancreatitis, NeutrophilLymphocyte Ratio, Platelet-Lymphocyte Ratio, Mean Platelet Volume

References

1. Balthazar EJ. CT diagnosis and staging of acute pancreatitis. Radiol Clin North Am 1989;27:19–37
2. Lerch MM, Adler G. Experimental animal models of acute pancreatitis. Int J Pancreatol 1994;15:159–70.
3. Suppiah A, Malde D, Arab T, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acutepancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17:675-81.
4. Xu ZS, Zhang FP, Zhang Y, et al.Prognostic role of the pre-treatment platelet-lymphocyte ratio in pancreatic cancer: A meta-analysis. Oncotarget 2017; 8: 99003-99012
5. Sandhaus LM, Meyer P. How useful are CBC and reticulocyte reports to clinicians? Am J Clin Pathol 2002;118: 787—93.
6. Gasparyan AY, Stavropoulos-Kalinoglou A, Toms TE, et al. Association of mean platelet volume with hypertension in rheumatoid arthritis. Inflamm Allergy Drug Targets 2010;9:45—50
7. Feng P, He C, Liao G, et al. Early enteral nutrition versus delayed enteral nutrition in acute pancreatitis: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2017; 96: e8648.
8. Yang Z, Dong L, Zhang Y, et al. Prediction of severe acute pancreatitis using a decisiontree model based on the revised atlanta classification of acute pancreatitis. PLoSOne 2015; 10: e0143486.
9. Ignatavicius P, Gulla A, Cernauskis K, et al. How severe is moderately severe acute pancreatitis? Clinical validation of revised 2012 Atlanta Classification. World J Gastroenterol 2017; 23: 7785-7790.
10. Ferreira Ade F, Bartelega JA, Urbano HC, et al. Acute pancreatitis gravity predictive factors: which and when to use them? Arq Bras Cir Dig. 2015 Jul-Sep;28(3):207-11
11. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis
12. M. England and M. C. Down, "Red-Cell-Volume Dıstrıbutıon Curves And The Measurement Of Anısocytosıs," The Lancet, vol. 303, no. 7860, pp. 701-703, 1974
13. K. Şenol, B. Saylam, F. Kocaay, et al. "Red cell distribution width as a predictor of mortality in acute pancreatitis," (in eng), Am J Emerg Med, vol. 31, no. 4, pp. 687-9, Apr 2013.
14. D. Wang. "Red cell distribution width predicts deaths in patients with acute pancreatitis," (in eng), J Res Med Sci, vol. 20, no. 5, pp. 424-8, May 2015
15. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96:776—81.
Jaremo P, Lindahl TL, Lennmark C, et al. The use of platelet density and volume measurements to estimatethe severity of preeclampsia. Eur J Clin Invest 2000;30: 1113—38.
17. Choi CU, Seo HS, Kim YK, et al. Can mean platelet volumepredict coronary vasospasm? Platelets 2011;22:173—8
18. Beyazit 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 Apr;36(2):162-8.
19. Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperativeneutrophil-lymphocyte ratio andoutcome from coronary artery bypass grafting.Am Heart J 2007; 154: 995–1002.
20. Suppiah A, Malde D, Arab T, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17(4): 675–81
21. Azab B, Jaglall N, Atallah JP. et al. Neutrophil-Lymphocyte Ratio as a Predictor of Adverse Outcomes of Acute Pancreatitis. Pancreatology. 2011;11(4):445-52.

There are 21 citations in total.

Details

Primary Language	Turkish
Subjects	Health Care Administration
Journal Section	Articles
Authors	Attila Önmez Ece Bilir This is me Serkan Torun
Publication Date	March 25, 2019
Acceptance Date	March 4, 2019
Published in Issue	Year 2019 Volume: 11 Issue: 1

Cite

APA	Önmez, A., Bilir, E., & Torun, S. (2019). Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki. Konuralp Medical Journal, 11(1), 24-29. https://doi.org/10.18521/ktd.492274
AMA	Önmez A, Bilir E, Torun S. Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki. Konuralp Medical Journal. March 2019;11(1):24-29. doi:10.18521/ktd.492274
Chicago	Önmez, Attila, Ece Bilir, and Serkan Torun. “Akut Pankreatit Şiddeti Ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği Ve Ortalama Platelet Volümü Arasındaki İlişki”. Konuralp Medical Journal 11, no. 1 (March 2019): 24-29. https://doi.org/10.18521/ktd.492274.
EndNote	Önmez A, Bilir E, Torun S (March 1, 2019) Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki. Konuralp Medical Journal 11 1 24–29.
IEEE	A. Önmez, E. Bilir, and S. Torun, “Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki”, Konuralp Medical Journal, vol. 11, no. 1, pp. 24–29, 2019, doi: 10.18521/ktd.492274.
ISNAD	Önmez, Attila et al. “Akut Pankreatit Şiddeti Ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği Ve Ortalama Platelet Volümü Arasındaki İlişki”. Konuralp Medical Journal 11/1 (March 2019), 24-29. https://doi.org/10.18521/ktd.492274.
JAMA	Önmez A, Bilir E, Torun S. Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki. Konuralp Medical Journal. 2019;11:24–29.
MLA	Önmez, Attila et al. “Akut Pankreatit Şiddeti Ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği Ve Ortalama Platelet Volümü Arasındaki İlişki”. Konuralp Medical Journal, vol. 11, no. 1, 2019, pp. 24-29, doi:10.18521/ktd.492274.
Vancouver	Önmez A, Bilir E, Torun S. Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki. Konuralp Medical Journal. 2019;11(1):24-9.