Turkiye Klinikleri Journal of Medical Sciences

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Multipl Skleroz Atağı ile Hematolojik İnflamatuar Parametreler Arasındaki İlişki: Retrospektif Çalışma
Association Between Hematological Inflammatory Markers and Attack Period in Multiple Sclerosis: Retrospective Study
Yasemin EKMEKYAPAR FIRATa, Ayşe Münife NEYALa, Pınar GÜNEL KARADENİZb
aSANKO Üniversitesi Tıp Fakültesi, Nöroloji ABD, Gaziantep, TÜRKİYE
bSANKO Üniversitesi Tıp Fakültesi, Biyoistatistik ABD, Gaziantep, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2021;41(4):431-7
doi: 10.5336/medsci.2021-84574
Article Language: TR
Full Text
ÖZET
 Amaç: Nötrofil/lenfosit oranı (NLO) ve monosit/lenfosit oranlarının (MLO), multipl sklerozun (MS) seyri ve progresyonu gibi klinik özelliklerini öngörmede yararlı belirteçler olabilecekleri bildirilmiştir. Dinamik değişiklerle karakterize bu inflamatuar parametrelerin MS'de inflamasyonun en belirgin olduğu ataklı dönemde farklılıklar göstermesi beklenebilir. Bu çalışmada, aynı MS hasta grubunda ataklı ve ataksız dönemlerdeki NLO, MLO ve platelet/lenfosit oranlarının (PLO) araştırılması amaçlanmıştır. Gereç ve Yöntemler: Son 3 yıl içinde akut atak nedeniyle tedavi edilmiş olan MS hastalarının tıbbi kayıtları tarandı. Dâhil edilme kriterlerine uyan 50 hasta çalışmaya alındı. Tüm olgularda iki tam kan sayımı örneğinden (atak sırasında metilprednizolon tedavisinden önce ve ilk tedaviden bir ay sonra alınan) ölçülen NLR, MLR ve PLR düzeyleri laboratuvar ve klinik parametrelere bağlı olarak hesaplandı, kıyaslandı ve değerlendirildi. Bulgular: Ataklı ve ataksız dönemdeki NLO değerleri arasında fark yokken, MLO ve PLO değerleri atak sırasında düşük bulundu (p=0,008, p=0,012). Yedi gün içinde başvuran hastaların MLO ve PLO'ları ataklı dönemde anlamlı düşükken (p=0,048, p=0,023), daha geç başvuranların sadece atak sırasındaki MLO değerleri düşüktü (p=0,037). Sonuç: NLO ve MS hastalarında, atağın ayrımında yararlı bir biyobelirteç olmayabilir. MLO ve PLO değerleri başvuru zamanına göre bazı farklılıklar göstermiştir. MLO ve PLO'nun MS ataklarında yararlı ve dinamik değişiklikler gösteren biyobelirteçler olup, olmadıkları araştırılmaya değer bir konudur.

Anahtar Kelimeler: Multipl skleroz; atak; nötrofil lenfosit oranı; platelet lenfosit oranı; monosit lenfosit oranı
ABSTRACT
 Objective: The neutrophil/lymphocyte ratios (NLR) and monocyte/lymphocyte ratios (MLR) reported as predictive markers for some clinical features of multiple sclerosis (MS). These inflammatory markers might differ during an MS attack where inflammation is expected to be most prominent in the clinical course. We aimed to investigate the NLR, MLR, and platelet/lymphocyte ratios (PLR) during the attack and non-attack periods in MS patients. Material and Methods: The medical records of MS patients that were treated for an acute MS attack in the last 3 years were reviewed. Fifty patients who met the inclusion criteria in the cohort were included into the present study. In all cases, NLR, MLR and PLR from 2 samples of complete blood counts (that were obtained during an attack before methylprednisolone treatment and at least 1 month after the first blood sample) were calculated and compared and also were evaluated according to laboratory and clinical parameters. Results: NLR values were similar in attack and non-attack periods. However, MLR and PLR values were found to be lower during attack (p=0.008, p=0.012, respectively). MLR and PLR were significantly lower during the attack period in the cases who admitted within 7 days (p=0.048, p=0.023, respectively), whereas, only MLR values were lower in the cases who admitted later (p=0.037). Conclusion: NLR does not seem as a useful biomarker for differentiating an MS attack. MLR and PLR values revealed some differences concerning the admission day. It might worth to investigate if MLR and PLR are dynamic and useful biomarkers in MS attacks in further prospective studies.

Keywords: Multiple sclerosis; attack; neutrophil lymphocyte ratio; platelet lymphocyte ratio; monocyte lymphocyte ratio
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