HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?

Yılmaz, Mustafa; gunesli, aylin

doi:10.5505/amj.2020.65688

HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?

Mustafa YILMAZ, (Başkent Üniversitesi, Tıp Fakültesi, Kardiyoloji Ana Bilim Dalı, Ankara, Türkiye)

Aylin GUNESLİ (Başkent Üniversitesi, Tıp Fakültesi, Radyoloji Ana Bilim Dalı, Ankara, Türkiye)

Ankara Medical Journal

7 3

Yıl: 2020 Cilt: 20 Sayı: 3 Sayfa Aralığı: 653 - 662 Metin Dili: Türkçe DOI: 10.5505/amj.2020.65688 İndeks Tarihi: 07-10-2020

HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?

Öz:

Amaç: Ortalama trombosit hacmi (OTH), kırmızı kan hücresi dağılım genişliği (KKDG), nötrofil-lenfosit oranı (NLO) ve lenfosit-monosit oranının (LMO) arteryel istenmeyen olaylar için öngördürücü olduğu bilinmesine rağmen derin ven trombozu (DVT) tanısında yerinin olup olmadığı net değildir. Bu çalışmanın amacı bunu değerlendirmektir. Bu amaçla OTH, KKDG, NLO ve LMO normal sağlıklı populasyonda ve DVT tanısı almış hastalarda ölçülerek karşılaştırılmıştır.Materyal ve Metot: Çalışma geriye dönük planlandı. Akut DVT tanısı konulmuş 77 hasta ve 67 sağlıklı gönüllünün OTH, KKDG, NLO ve LMO değerleri kaydedildi ve arada istatistiksel anlamlı fark olup olmadığı değerlendirildi. Ek olarak hasta grubunda bu hematolojik parametreler ile başvuru anındaki D-dimer değerleri arasında korelasyon olup olmadığı araştırıldı.Bulgular: Hasta grubunda OTH, KKDG ve NLO değerleri kontrol grubuna göre istatistiksel anlamlı olarak daha yüksekti (9,68±1,89 vs. 8,9±1,01, p=0,003, 12,77±3,67 vs. 11,15±2,16, p=0,002 ve 1,91±0,84 vs. 1,51±0,54, p=0,001, sırasıyla). Lenfosit-monosit oranı ise hasta grubunda daha düşük bulundu (6,27±3,14 vs. 8,85±3,92, p<0,001). D-dimer ile OTH, KKDG ve NLO arasında pozitif, LMO ile ise negatif yönlü korelasyon bulundu (sırasıyla; r=0,693, p<0,001, r=0,896, p<0,001, r=0,798, p<0,001 ve r= -0,287, p=0,011)Sonuç: Akut DVT hastalarında OTH, KKDG, NLO sağlıklı popülasyona göre artmış, LMO ise azalmıştı. Bu bulgular bize, bu belirteçlerin akut DVT tanısında yardımcı olabileceğini düşündürebilir.

Anahtar Kelime:

CAN HEMATOLOGICAL PARAMETERS PREDICT THE DIAGNOSIS OF DEEP VENOUS THROMBOSIS?

Öz:

Objectives: Although it is known that mean platelet volume (MPV), red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) are predictive for arterial thrombosis and adverse events, it is not clear whether they help in the diagnosis of deep vein thrombosis. The aim of the study was to evaluate it. For this purpose, MPV, RDW, NLR, and LMR were measured and compared between in patients with DVT and control groups. Materials and Methods: In a retrospective study, a total of 144 subjects (77 patients with DVT, 67 control) were examined. Mean platelet volume, RDW, NLR, and LMR were calculated and compared between the groups. It was investigated whether there was a correlation between D-dimer values and MPV, RDW, NLR, LMR. Results: Mean platelet volume, RDW, and NLR values were significantly higher in the patient group than in the control group (9.68±1.89 vs. 8.9±1.01, p=0.003, 12.77±3.67 vs. 11.15±2.16, p=0.002 and 1.91±0.84 vs. 1.51±0.54, p=0.001, respectively). On the other hand, LMR was lower in the patient group (6.27±3.14 vs. 8.85±3.92, p<0.001). There was a positive correlation between D-dimer and MPV, RDW, NLR while there was a negative correlation between D-dimer and LMR (r=0.693, p<0.001, r=0.896, p<0.001, r=0.798, p<0.001 and r = -0.287, p=0.011, respectively). Conclusion: Mean platelet volume, RDW, and NLR increase but LMR decrease in patients with DVT. These results suggesting that these markers may help in the diagnosis of acute DVT.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Olaf M, Cooney R. Deep Venous Thrombosis. Emerg Med Clin North Am. 2017;35(4):743-70.
2. Bevis PM, Smith FCT. Deep vein thrombosis. Surgery (Oxford) 2016;34: 159–64.
3. Nordstrom M, Lindblad B, Bergqvist D, et al. A prospective study of the incidence of deep-vein thrombosis within a defined urban population. J Intern Med 1992;232(2):155–60.
4. Dickson BC. Venous thrombosis: on the history of Virchow’s triad. Univ Toronto Med J 2004;81:166– 71.
5. Bauersachs RM. Clinical presentation of deep vein thrombosis and pulmonary embolism. Best Pract Res Clin Haematol 2012;25(3):243–51.
6. Klovaite J, Benn M, Yazdanyar S, Nordestgaard BG. High platelet volume and increased risk of myocardial infarction: 39,531 participants from the general population. J Thromb Haemost. 2011;9(1):49–56.
7. Slavka G, Perkmann T, Haslacher H, et al. Mean platelet volume may represent a predictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol. 2011;31(5):1215–18.
8. Uysal OK, Duran M, Ozkan B, et al. Red cell distribution width is associated with acute myocardial infarction in young patients. Cardiol J 2012;19(6):597–602.
9. Ramirez-Moreno JM, Gonzalez-Gomez M, Ollero-Ortiz A, et al. Relation between red blood cell distribution width and ischemic stroke: a case-control study. Int J Stroke 2013;8(6):E36.
10. Dong CH, Wang ZM, Chen SY. Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis. Clin Biochem. 2018 ;52:131-6.
11. Wang Q, Ma J, Jiang Z, Wu F, Ping J, Ming L. Association of lymphocyte-to-monocyte ratio with inhospital and long-term major adverse cardiac and cerebrovascular events in patients with STelevated myocardial infarction. Medicine (Baltimore). 2017;96(34):e7897.
12. Tanaka S, Nishigami K, Taniguchi N, et al. Criteria for ultrasound diagnosis of deep venous thrombosis of lower extremities. J Med Ultrason (2001). 2008;35(1):33-6.
13. Siller-Matula JM, Arbesu I, Jilma B, Maurer G, Lang IM, Mannhalter C. Association between the rs342293 polymorphism and adverse cardiac events in patients undergoing percutaneous coronary intervention. Thromb Haemost. 2014;111(6):1060–6.
14. Kamath S, Blann AD, Lip GY. Platelet activation: Assessment and quantification. Eur Heart J. 2001;22(17):1561–71.
15. Nakamura T, Uchiyama S, Yamazaki M, Okubo K, Takakuwa Y, Iwata M. Flow cytometric analysis of reticulated platelets in patients with ischemic stroke. Thromb Res. 2002;106(4-5):171–7.
16. Guthikonda S, Alviar CL, Vaduganathan M, et al. Role of reticulated platelets and platelet size heterogeneity on platelet activity after dual antiplatelet therapy with aspirin and clopidogrel in patients with stable coronary artery disease. J Am Coll Cardiol. 2008;52(9):743–9.
17. Yardan T, Meric M, Kati C, Celenk Y, Atici AG. Mean platelet volume and mean platelet volume/platelet count ratio in risk stratification of pulmonary embolism. Medicina (Kaunas). 2016;52(2):110-5.
18. Günay E, Sarinc Ulasli S, Kacar E, et al. Can platelet indices predict obstruction level of pulmonary vascular bed in patients with acute pulmonary embolism?. Clin Respir J. 2014;8(1):33-40.
19. Zorlu A, Bektasoglu G, Guven FM, et al. Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism. Am J Cardiol 2012;109(1):128–34.
20. Ozsu S, Abul Y, Gunaydin S, Orem A, Ozlu T. Prognostic Value of Red Cell Distribution Width in Patients With Pulmonary Embolism. Clin Appl Thromb Hemost. 2014;20(4):365-70.
21. Pehlivanlar Küçük M, Öztuna F, Abul Y, Özsu S, Kutlu M, Özlü T. Prognostic value of red cell distribution width and echocardiographic parameters in patients with pulmonary embolism. Adv Respir Med. 2019;87(2):69-76.
22. Cay N, Unal O, Kartal MG, Ozdemir M, Tola M. Increased level of red blood cell distribution width is associated with deep venous thrombosis. Blood Coagul Fibrinolysis. 2013;24(7):727-31.
23. Zöller B, Melander O, Svensson P, Engström G. Red cell distribution width and risk for venous thromboembolism: a population-based cohort study. Thromb Res. 2014;133(3):334-9.
24. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133(4):628–32.
25. Fujita B, Strodthoff D, Fritzenwanger M, et al. Altered red blood cell distribution width in overweight adolescents and its association with markers of inflammation. Pediatr Obes 2013;8(5):385–91.
26. Kuplay H, Erdoğan SB, Bastopcu M, Arslanhan G, Baykan DB, Orhan G. The neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio correlate with thrombus burden in deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2020;8(3):360-4.
27. Farah R, Nseir W, Kagansky D, Khamisy-Farah R. The role of neutrophil‐lymphocyte ratio, and mean platelet volume in detecting patients with acute venous thromboembolism. J Clin Lab Anal. 2020;34(1):e23010.
28. Orfanu AE, Popescu C, Leuștean A, et al. The importance of haemogram parameters in the diagnosis and prognosis of septic patients. J Crit Care Med. 2017;3(3):105‐10. 29. Branchford BR, Carpenter SL. The role of inflammation in venous thromboembolism. Front Pediatr 2018;6:142.
30. Rabinovich A, Cohen JM, Cushman M, et al. Association between inflammation biomarkers, anatomic extent of deep venous thrombosis, and venous symptoms after deep venous thrombosis. J Vasc Surg Venous Lymphat Disord 2015;3(4):347-53.
31. Wang Q, Ma J, Jiang Z, Wu F, Ping J, Ming L. Association of lymphocyte-to-monocyte ratio with inhospital and long-term major adverse cardiac and cerebrovascular events in patients with STelevated myocardial infarction. Medicine (Baltimore). 2017;96(34):e7897.
32. Kiris T, Celik A, Varis E, et al. Association of lymphocyte-to-monocyte ratio with the mortality in patients with ST-elevation myocardial infarction who underwent primary percutaneous coronary intervention. Angiology 2017;68(8):707–15.
33. Ertem AG, Yayla C, Acar B, et al. Relation between lymphocyte to monocyte ratio and short-term mortality in patients with acute pulmonary embolism. Clin Respir J. 2018;12(2):580-6.

APA	Yılmaz M, gunesli a (2020). HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. , 653 - 662. 10.5505/amj.2020.65688
Chicago	Yılmaz Mustafa,gunesli aylin HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. (2020): 653 - 662. 10.5505/amj.2020.65688
MLA	Yılmaz Mustafa,gunesli aylin HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. , 2020, ss.653 - 662. 10.5505/amj.2020.65688
AMA	Yılmaz M,gunesli a HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. . 2020; 653 - 662. 10.5505/amj.2020.65688
Vancouver	Yılmaz M,gunesli a HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. . 2020; 653 - 662. 10.5505/amj.2020.65688
IEEE	Yılmaz M,gunesli a "HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?." , ss.653 - 662, 2020. 10.5505/amj.2020.65688
ISNAD	Yılmaz, Mustafa - gunesli, aylin. "HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?". (2020), 653-662. https://doi.org/10.5505/amj.2020.65688

APA	Yılmaz M, gunesli a (2020). HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. Ankara Medical Journal, 20(3), 653 - 662. 10.5505/amj.2020.65688
Chicago	Yılmaz Mustafa,gunesli aylin HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. Ankara Medical Journal 20, no.3 (2020): 653 - 662. 10.5505/amj.2020.65688
MLA	Yılmaz Mustafa,gunesli aylin HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. Ankara Medical Journal, vol.20, no.3, 2020, ss.653 - 662. 10.5505/amj.2020.65688
AMA	Yılmaz M,gunesli a HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. Ankara Medical Journal. 2020; 20(3): 653 - 662. 10.5505/amj.2020.65688
Vancouver	Yılmaz M,gunesli a HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?. Ankara Medical Journal. 2020; 20(3): 653 - 662. 10.5505/amj.2020.65688
IEEE	Yılmaz M,gunesli a "HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?." Ankara Medical Journal, 20, ss.653 - 662, 2020. 10.5505/amj.2020.65688
ISNAD	Yılmaz, Mustafa - gunesli, aylin. "HEMATOLOJİK PARAMETRELER DERİN VEN TROMBOZU TANISINDA YARDIMCI OLABİLİR Mİ?". Ankara Medical Journal 20/3 (2020), 653-662. https://doi.org/10.5505/amj.2020.65688