Merkezi sinir sistemi enfeksiyonlarının tanısında beyin omurilik sıvısı ve serum pentraksin 3 düzeylerinin akut faz reaktanlarıyla karşılaştırılması
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Tarih
2022
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Merkezi sinir sistemi (MSS) enfeksiyonları hastane yatışlarının %1'inden azını oluştursalar da morbidite ve mortalite yüksekliği nedeniyle tıbbi acillerdendir. Erken tanıda Lomber ponksiyon (LP) en değerli yaklaşımdır. LP yapılamadığı durumlarda kinik, radyolojik görüntülemeler ve akut faz reaktanları yardımcı olmaktadır. Son yıllarda enfeksiyon hastalıklarının tanısında önem kazanan pentraksin 3'ün (PTX3) katkıda bulunabileceği düşünülmektedir. Bu çalışmayla MSS enfeksiyonlarının tanısında PTX3'ün biyobelirteç olarak yaralı olup olmayacağı ve akut faz reaktanlarıyla karşılaştırılması amaçlanmıştır. Gereç ve yöntem: Elli hasta olarak planlanan bu çalışma, Covid pandemisi nedeniyle ancak 41 hastayla tamamlandı. Hastalardan LP yoluyla elde edilmiş beyin omurilik sıvısı (BOS) ve kanda PTX3 düzeyleri çalışıldı. PTX3 düzeyleri, BOS ve kandaki bazı parametrelerle karşılaştırıldı. Bulgular: Çalışmaya dahil edilen 41 hastanın BOS PTX3 düzeylerinin serum PTX3 düzeylerinden daha yüksek olduğu görüldü (10.11 e karşı 0,41 ng/mL). Bu fark istatistiksel olarak anlamlı bulunamadı (p:0,085). Serum PTX3 düzeyleri ile klinik bulgular, BOS ve kan parametreleri arasında istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Hastaların BOS Pentraksin-3 düzeyleri ile klinik, BOS ve kan parametreleri arasında da anlamlı farklılık saptanmadı (p>0,05). BOS PTX3 düzeyleriyle Glaskow Koma Skoru arasında negatif yönde orta düzeyde ilişki saptanırken (r=-0,354, p=0,023), BOS PTX3 düzeyleriyle BOS protein düzeyleri arasında pozitif yönde orta düzeyde ilişki saptandı (r=0,322, p=0,040). Sonuç: MSS enfeksiyonu olan hastalarda BOS pentraksin-3 seviyeleri, serum pentraksin-3 seviyelerine göre daha yüksek bulunmuş olsa da istatiksel olarak anlamlı bulunmamıştır. Daha geniş çaplı çalışmalar ve araştırmalara ihtiyaç vardır. Anahtar Sözcükler: Merkezi sinir sistemi enfeksiyonları, Pentraksin 3, Beyin omurilik sıvısı
Objective: Although central nervous system (CNS) infections constitute less than 1% of all hospitalizations, they are among important emergencies due to morbidity and deaths. Early diagnosis and treatment are very important, and each hour of delay increases the patient's morbidity and mortality risk. Lumbar puncture is the most valuable approach to diagnosis. However, in cases where lumbar puncture cannot be performed, clinical findings, radiological imaging, acute phase reactants and hemogram help the diagnosis. Pentraxin 3 (PTX3), which has gained importance in the diagnosis of infectious diseases due to limitations in diagnosis in recent years, is thought to contribute. The aim of this study was to examine the significance of PTX3 for diagnosis in central nervous system infections and to compare it with other acute phase reactants. Material and Methods: Patients diagnosed with central nervous system infection were included in the study. After taking informed consent from the patients, lumbar puncture was performed and cerebrospinal fluid and blood samples were taken. Blood samples and CSF were studied with kits. The obtained data were analyzed by using the SPSS 21 package program. Results: 41 patients diagnosed with central nervous system infection were included in the study. CSF Pentraxin-3 levels appear to be higher than serum Pentraxin-3 levels (10.11 vs. 0.41 ng/mL). However, this difference was not found to be statistically significant (p: 0.085). There was no statistically significant difference between serum PTX3 levels and clinical outcomes, CSF and blood parameters (p>0.05). There was no significant difference between CSF Pentraxin-3 levels and clinical outcomes, CSF and blood parameters of the patients included in the study (p>0.05). There was a moderate negative correlation between CSF PTX3 levels and Glasgow Coma Score (r=-0.354, p=0.023). A moderate positive correlation was found between CSF PTX3 levels and CSF protein levels (r=0.322, p=0.040). Conclusion: As a result of the study, an increase was observed in CSF pentraxin-3 levels, while no significant increase was found in serum pentraxin-3 levels. Although no significant difference was found in serum pentaxin-3 levels, it is thought that these significant results may be useful in diagnosis and differential diagnosis and contribute to the literature. Key words: Central nervous system infections, Pentraxin 3, Cerebrospinal fluid
Objective: Although central nervous system (CNS) infections constitute less than 1% of all hospitalizations, they are among important emergencies due to morbidity and deaths. Early diagnosis and treatment are very important, and each hour of delay increases the patient's morbidity and mortality risk. Lumbar puncture is the most valuable approach to diagnosis. However, in cases where lumbar puncture cannot be performed, clinical findings, radiological imaging, acute phase reactants and hemogram help the diagnosis. Pentraxin 3 (PTX3), which has gained importance in the diagnosis of infectious diseases due to limitations in diagnosis in recent years, is thought to contribute. The aim of this study was to examine the significance of PTX3 for diagnosis in central nervous system infections and to compare it with other acute phase reactants. Material and Methods: Patients diagnosed with central nervous system infection were included in the study. After taking informed consent from the patients, lumbar puncture was performed and cerebrospinal fluid and blood samples were taken. Blood samples and CSF were studied with kits. The obtained data were analyzed by using the SPSS 21 package program. Results: 41 patients diagnosed with central nervous system infection were included in the study. CSF Pentraxin-3 levels appear to be higher than serum Pentraxin-3 levels (10.11 vs. 0.41 ng/mL). However, this difference was not found to be statistically significant (p: 0.085). There was no statistically significant difference between serum PTX3 levels and clinical outcomes, CSF and blood parameters (p>0.05). There was no significant difference between CSF Pentraxin-3 levels and clinical outcomes, CSF and blood parameters of the patients included in the study (p>0.05). There was a moderate negative correlation between CSF PTX3 levels and Glasgow Coma Score (r=-0.354, p=0.023). A moderate positive correlation was found between CSF PTX3 levels and CSF protein levels (r=0.322, p=0.040). Conclusion: As a result of the study, an increase was observed in CSF pentraxin-3 levels, while no significant increase was found in serum pentraxin-3 levels. Although no significant difference was found in serum pentaxin-3 levels, it is thought that these significant results may be useful in diagnosis and differential diagnosis and contribute to the literature. Key words: Central nervous system infections, Pentraxin 3, Cerebrospinal fluid
Açıklama
Anahtar Kelimeler
Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları, Clinical Microbiology and Infectious Diseases
