Acil serviste serebrovasküler hastalık tanısı alan hastalarda serum chemerin düzeylerinin araştırılması
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Dosyalar
Tarih
2022
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnme koroner arter hastalığından sonra dünyada ikinci sıklıkta görülen mortalite nedenidir. İskemik inme hastalarının acil servis başvurularında uygun tedavilerin zamanında ve gerektiği gibi başlanamaması kötü prognoz ile sonuçlanmaktadır. Çalışmamızda chemerin yeni bir SVH belirteci olarak kullanılıp kullanılamayacağının ve mevcut kullanılan diğer radyolojik ve laboratuvar araçları ile kombinasyonunun tanısal olarak değerlendirilmesini amaçladık. Çalışmaya Trakya Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Erişkin Acil Servisi’ne 30/03/2021 ile 30/08/2021 tarihleri arasında başvuran kişilerden 26 hemorajik inme, 26 iskemik inme ve herhangi bir hastalığı olmayan 26 sağlıklı gönüllü dahil edilmiştir. Hastaların demografik bilgileri, vital bulguları, laboratuvar değerleri, National Institutes of Health Stroke Scale Scores (NIHSS skoru- Ulusal inme sağlık ölçeği skalası), şikayet başlaması ile başvuru arasında geçen süre, durumunun sonuçları kaydedilmiştir. Hasta ve kontrol grubu serumlarında serum chemerin düzeyleri incelenmiştir. Çalışmaya toplam 78 gönüllü dahil edilmiş olup hasta sayısı 52, sağlıklı kontrol grubu gönüllü sayısı ise 26 idi. Hastaların %71’i erkek ve %29’u da kadındı. Hemorajik inme tanısı koyulan hastaların ortalama yaşı 59,92±18,08 yıl, iskemik inmede 71,96±12,72 yıldı. Hastaların en sık olarak %25 oranla başvuru şikayeti kas gücü kaybıydı. Hastaların %48’inin YBÜ’de takip edildiği ve mortalite oranının %38,4 olduğu tespit edildi. Chemerin düzeyi hemorajik inme geçiren hastalarda 5,770.00±2,067.95, iskemik inme geçirenlerde 6,281.46±4,019.50, kontrol grubunda ise 1042.7±539,2’dir. Kontrol grubundakilerin hemorajik inme ve iskemik inme gurubundakilere göre chemerin düzeyininin anlamlı olarak düşük olduğu saptandı. ROC analizinde hemorajik veya iskemik inmeyi tahmin edebilecek chemerin düzeyi için istatistiksel açıdan chemerin düzeyinde anlamlı sayılacak cut-off saptandı. Bu cut-off >2201 düzeyinde bulunmuş olup sensivite %88,5 spesifite %100 olarak tespit edildi. Chemerin düzeyinde tespit edilen cut-off değeri hemorajik veya iskemik inmenin dışlanması ya da inmeye yönlendirilmesi açısından değerli bir sonuçtur. Bu değerin daha geniş bir popülasyonla ve çok merkezli çalışmalar ile desteklenmesi sağlandığında SVH tanısı konulması, hastaların acil serviste geçirdikleri sürenin uzamaması ve görüntüleme yöntemlerinin gereksiz kullanımının önüne geçilmesi ile tanı ve tedavi maliyetlerinde de azalma sağlanabileceği düşünülmektedir.
Stroke is the second most common cause of mortality in the world after coronary artery disease. Failure to start treatment on time and properly in the emergency department admissions of ischemic stroke patients results in a poor prognosis. In our study, we aimed to evaluate whether chemerin can be used as a new SVH marker and its combination with other currently used radiological and laboratory tools. This study was conducted with 26 healthy volunteers without any disease, 26 hemorrhagic stroke, 26 ischemic stroke, from people who applied to Trakya University Health Application and Research Center Adult Emergency Service between 30/03/2021 and 30/08/2021. Demographic information, vital signs, laboratory values, National Institutes of Health Stroke Scale Scores (NIHSS score), the time between the onset of the complaint and the admission, and the outcome of the patients were recorded. Serum chemerin levels of the patient and control groups were examined. A total of 78 volunteers were included in the study, and the number of patients was 52 and the number of healthy control group volunteers was 26. 71% of the patients were male and 29% were female. The mean age of patients diagnosed with hemorrhagic stroke was 59.92±18.08 years, and 71.96±12.72 years in ischemic stroke. The most common complaint of the patients was loss of muscle strength with a rate of 25%. It was determined that 48% of the patients were followed in the intensive care unit and the mortality rate was 38.4%. Chemerin level was 5,770.00±2,067.95 in patients with hemorrhagic stroke, 6,281.46±4,019.50 in patients with ischemic stroke and 1042.7±539.2 in the control group. Chemerin levels were found to be significantly lower in the control group compared to those in the hemorrhagic stroke and ischemic stroke groups. In the ROC analysis, a statistically significant cut-off was found at the chemerin level for the chemerin level that could predict hemorrhagic or ischemic stroke. This cut-off was found to be >2201 and the sensitivity was 88.5%, the specificity was 100%. The cut-off value determined at the chemerin level is a valuable result in terms of excluding or directing hemorrhagic or ischemic stroke. When this value is supported by a larger population and multicenter studies, it is thought that diagnosis and treatment costs can be reduced by diagnosing SVH, not prolonging the time spent in the emergency room, and preventing unnecessary use of imaging methods.
Stroke is the second most common cause of mortality in the world after coronary artery disease. Failure to start treatment on time and properly in the emergency department admissions of ischemic stroke patients results in a poor prognosis. In our study, we aimed to evaluate whether chemerin can be used as a new SVH marker and its combination with other currently used radiological and laboratory tools. This study was conducted with 26 healthy volunteers without any disease, 26 hemorrhagic stroke, 26 ischemic stroke, from people who applied to Trakya University Health Application and Research Center Adult Emergency Service between 30/03/2021 and 30/08/2021. Demographic information, vital signs, laboratory values, National Institutes of Health Stroke Scale Scores (NIHSS score), the time between the onset of the complaint and the admission, and the outcome of the patients were recorded. Serum chemerin levels of the patient and control groups were examined. A total of 78 volunteers were included in the study, and the number of patients was 52 and the number of healthy control group volunteers was 26. 71% of the patients were male and 29% were female. The mean age of patients diagnosed with hemorrhagic stroke was 59.92±18.08 years, and 71.96±12.72 years in ischemic stroke. The most common complaint of the patients was loss of muscle strength with a rate of 25%. It was determined that 48% of the patients were followed in the intensive care unit and the mortality rate was 38.4%. Chemerin level was 5,770.00±2,067.95 in patients with hemorrhagic stroke, 6,281.46±4,019.50 in patients with ischemic stroke and 1042.7±539.2 in the control group. Chemerin levels were found to be significantly lower in the control group compared to those in the hemorrhagic stroke and ischemic stroke groups. In the ROC analysis, a statistically significant cut-off was found at the chemerin level for the chemerin level that could predict hemorrhagic or ischemic stroke. This cut-off was found to be >2201 and the sensitivity was 88.5%, the specificity was 100%. The cut-off value determined at the chemerin level is a valuable result in terms of excluding or directing hemorrhagic or ischemic stroke. When this value is supported by a larger population and multicenter studies, it is thought that diagnosis and treatment costs can be reduced by diagnosing SVH, not prolonging the time spent in the emergency room, and preventing unnecessary use of imaging methods.
Açıklama
Anahtar Kelimeler
İnme, Chemerin, NIHSS, Stroke
