Acil serviste tanı alan akut pankreatit hastalarında serum calcipressin-1 düzeyinin araştırılması
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Tarih
2021
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Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Akut pankreatit, pankreas sindirim enzimlerinin herhangi bir faktörle inaktif halden aktif hale geçerek pankreas ve çevre dokuları inflame ederek yaygın inflamasyon oluşturduğu, karın ağrısı ve kanda pankreas enzim seviyelerinin yüksekliği ile seyreden, tanısı pankreatik enzim yüksekliği ve radyolojik bulgular ile konulan, lokal ve sistemik komplikasyonlara neden olabilen, mortalitesi ve morbiditesi yüksek olan bir pankreas hastalığıdır Calsipressin-1 (RCAN-1) düşük miktarda olan oksidatif strese karşı geçici olarak apopitozunu engellemektedir. Calsipressinin kardiyak hipertrofi ve aterosklerotik hastalıklar, Down sendromu ve alzheimer hastalığı gibi hastalıklarda önemli rolü olduğu gösterilmiş fakat pankreas üzerindeki spesifik rolü yeterince çalışılmamıştır. Çalışmamızda calcipressin-1 düzeylerinin AP hastalarında hem tanı hem de mortalite açısından kullanılabilirliğini araştırmak amaçlandı. Çalışmamız acil servise başvuran akut pankreatit tanısı alan 74 hasta ile acil serviste ciddi müdahale gerektirmeyen tanılar alan 74 adet kontrol grubu ile gerçekleştirildi. Çalışmamıza katılan 148 kişinin ortalama yaşı 53,3±16,6 yıl, %53,3’ü erkek iken %46,7’si kadındı. RCAN1 düzeylerinin ortalama değeri; hasta grubunda 1002,4±353,1 pg/ml, kontrol grubunda 421,9±81,1 pg/ml olarak bulundu. Akut pankreatit tanılı hastalarda, sağlıklı bireylere göre anlamlı olarak Calcipressin-1 düzeyleri çok daha yüksek tespit edildi. Akut pankreatit tanılı hastaların yaşı, cinsiyeti, kronik hastalık sayıları, etiyolojik nedenleri, vital bulguları, amilaz değerleri, tüm laboratuvar değerleri, Ranson ve BISAP skorlarının ile RCAN1 düzeyleri arasında anlamlı doğrusal ilişki bulunmadı. Lipaz değerleri ile RCAN1 değerleri arasında ise çok zayıf, pozitif yönlü, doğrusal bir ilişki tespit edildi. Hastaların mortalite riskini etkileyen faktörlerin belirlenmesi amacıyla basit lojistik regresyon analizi yapıldı. Oluşturduğumuz modelin AUC değeri 0.988, sensivitesi %100, spesifitesi %91 olup Sistolik Kan Basıncı, nabız, CRP ve Total Bilirubin parametrelerinde oluşmaktadır. Sonuç olarak calsipressin-1 plazma düzeyinin akut pankreatit tanısında yardımcı olduğu görüldü. Fakat mortalite ve akut pankreatit şiddetini değerlendirme açısından yeterli olmadığı bulundu. Daha çok sayıda kişi ile yapılacak daha geniş çalışmalarla mortalite ve akut pankreatit şiddetiyle ilgili daha net bilgiler elde edileceğini ve oluşturulan mortalite tahmin modelinin acil servis kullanımı için daha pratik olduğunu düşünmekteyiz.
Acute pancreatitis is a pancreas disease caused by pancreatic digestive enzymes which become active from inactive factors causing widespread inflammation by inflaming the pancreas and surrounding tissues, diagnosed by elevated pancreatic enzymes and radiolgocal findings which can cause local and systemic complications with high rate of mortality and morbidity. Calsipressin-1 (RCAN-1) prevents apoptosis temporarily against low level of oxidative stress. It has been observed that Calcipressin has played an important role in diseases such as cardiac hypertrophy and atherosclerotic diseases, Down syndrome and Alzheimer's disease, but its specific role on the pancreas has not been sufficiently studied. The aim of our study is to investigate the usability of calcipressin-1 levels concerning diagnosis and mortality in AP patients. Our study was carried out with 74 patients diagnosed with acute pancreatitis who had admitted to the emergency service and 74 control groups who received other diagnoses that did not require serious intervention in the emergency department. The average age of 148 people participating in our study was 53.3 ± 16.6 years, 53.3% were male and 46.7% were female. Average value of RCAN1 levels were found 1002.4 ± 353.1 pg / ml in the patient group and 421.9 ± 81.1 pg / ml in the control group. Calcipressin-1 levels were significantly higher in patients with acute pancreatitis than healthy individuals. No significant linear relationship was detected between the age, gender, number of chronic diseases, etiological causes, vital signs, amylase values, all laboratory values, Ranson and BISAP scores and RCAN1 levels of patients diagnosed with acute pancreatitis. A very weak, positive, linear relationship was observed between lipase values and RCAN1 values. Simple logistic regression analysis was performed to determine the factors affecting the mortality risk of the patients. The AUC value of the model that we have created is 0.988, its sensitivity is 100%, its specificity is 91%, and it consists of Systolic Blood Pressure, heart rate, CRP and Total Bilirubin parameters. As a result, calsipressin-1 plasma level was observed to be helpful in the diagnosis of acute pancreatitis. However, it was detected to be insufficient in terms of evaluating mortality and acute pancreatitis severity. We consider that more clear information about mortality and the severity of acute pancreatitis will be obtained with studies to be conducted with more people and that the mortality prediction model created is more practical for emergency department use.
Acute pancreatitis is a pancreas disease caused by pancreatic digestive enzymes which become active from inactive factors causing widespread inflammation by inflaming the pancreas and surrounding tissues, diagnosed by elevated pancreatic enzymes and radiolgocal findings which can cause local and systemic complications with high rate of mortality and morbidity. Calsipressin-1 (RCAN-1) prevents apoptosis temporarily against low level of oxidative stress. It has been observed that Calcipressin has played an important role in diseases such as cardiac hypertrophy and atherosclerotic diseases, Down syndrome and Alzheimer's disease, but its specific role on the pancreas has not been sufficiently studied. The aim of our study is to investigate the usability of calcipressin-1 levels concerning diagnosis and mortality in AP patients. Our study was carried out with 74 patients diagnosed with acute pancreatitis who had admitted to the emergency service and 74 control groups who received other diagnoses that did not require serious intervention in the emergency department. The average age of 148 people participating in our study was 53.3 ± 16.6 years, 53.3% were male and 46.7% were female. Average value of RCAN1 levels were found 1002.4 ± 353.1 pg / ml in the patient group and 421.9 ± 81.1 pg / ml in the control group. Calcipressin-1 levels were significantly higher in patients with acute pancreatitis than healthy individuals. No significant linear relationship was detected between the age, gender, number of chronic diseases, etiological causes, vital signs, amylase values, all laboratory values, Ranson and BISAP scores and RCAN1 levels of patients diagnosed with acute pancreatitis. A very weak, positive, linear relationship was observed between lipase values and RCAN1 values. Simple logistic regression analysis was performed to determine the factors affecting the mortality risk of the patients. The AUC value of the model that we have created is 0.988, its sensitivity is 100%, its specificity is 91%, and it consists of Systolic Blood Pressure, heart rate, CRP and Total Bilirubin parameters. As a result, calsipressin-1 plasma level was observed to be helpful in the diagnosis of acute pancreatitis. However, it was detected to be insufficient in terms of evaluating mortality and acute pancreatitis severity. We consider that more clear information about mortality and the severity of acute pancreatitis will be obtained with studies to be conducted with more people and that the mortality prediction model created is more practical for emergency department use.
Açıklama
Anahtar Kelimeler
Calsipressin-1, Akut pankreatit, Mortalite, Calsipressin-1, Acute pancreatitis, Mortality
