HAFÝF VE ORTA DERECE KOAH ALEVLENMELERÝNDE EOZÝNOFÝLÝNÝN ROLÜ

Amaç: Hafif ve orta derece KOAH alevlenmesi olan hastalarda serum eozinofil deðerlerinin alevlenme þiddeti ile iliþkisini belirlemek. Yöntem ve Gereç: 01 Ocak-31 Aralýk 2017 tarihleri arasýnda Göðüs hastalýklarý polikliniðine müracaat eden KOAH tanýlý 254 hastanýn dosya verileri retrospektif olarak tarandý. Klinik ve laboratuvar bulgularýna göre ayaktan tedavi ile takip edilen hastalar “hafif derecede alevlenme, grup 1” ve hospitalize edilerek takip edilen hastalar ise “orta derecede alevlenme, grup 2” olarak iki gruba ayrýldý. Ýki grup arasýnda hastalarýn demografik özellikleri ve baþta eozinofil olmak üzere biyokimyasal deðerleri karþýlaþtýrýldý. Bulgular: Hafif derecede alevlenme tanýlý hastalarda serum eozinofil (2.4±1.7’e karþýlýk 1.1±1.3, p<0.001) ve lenfosit (23.7±9.2’e karþýlýk 14.7±8.5, p<0.001) oranlarý anlamlý derecede daha yüksek bulundu. Bunun aksine nötrofil oranlarý ise orta derecede alevlenme tanýlý hastalarda daha yüksek (%75.5±10.6’e karþýlýk %64.5±10.2, p<0.001) idi. Benzer þekilde hS-CRP (62.1±56.9’e karþýlýk 18.7±11.6, p<0.001) ve nötrofil/lenfosit oraný (9.1±12.8’e karþýlýk 3.5±2.6, p<0.001) orta derecede alevlenme tanýlý hastalarda anlamlý derecede daha yüksek idi. Çalýþmamýzda serum eozinofili için üst limiti olarak %2 deðeri alýndýðýnda, orta derecede alevlenme tanýlý hastalarda, %2 nin altýnda olan hasta oranýnýn anlamlý derecede daha yüksek (%78.8’e karþýlýk %46.3, p<0.001) olduðu sonucuna varýldý. Sonuç: KOAH alevlenmelerinde, serum eozinofil sayýsýnýn deðiþken olabileceði, bu hastalarda verilecek optimal tedavi þeklinin belirlenmesinde klinik ve laboratuvar bulgularýnýn birlikte deðerlendirilmesi gerekir.

THE ROLE OF EOSINOPHILS AT MILD AND MODERATE COPD EXACERBATIONS

Aim: To determine the relationship between serum eosinophil values with exacerbation severity in patients with mild and moderate Chronic Obstructive Pulmonary Disease Exacerbation. Material and Methods: Data of 254 patients diagnosed as COPD who applied to the Chest Diseases Polyclinic between January 1st with December 31th of 2017 were retrospectively reviewed. Patients were divided into two groups according to their clinical and laboratory findings; patients treated and followed up with outpatient treatment named as “mildly exacerbated-group 1”, and patients treated and followed up as hospitalized named as “ moderately exacerbated-group 2”. The demographic characteristics of the patients and their biochemical values, especially eosinophil value, were compared between the two groups. Results: Serum eosinophils (2.4±1.7 vs 1.1±1.3, p <0.001) and lymphocytes (23.7±39.2 versus 14.7±8.5, p <0.001) were significantly higher in patients with mild exacerbation. In contrast, neutrophil rates were higher in patients diagnosed with moderate exacerbation (75.5±10.6% versus 64.5±10.2%, p <0.001). Similarly, hS-CRP (62.1±56.9 versus 18.7±11.6, p <0.001) and neutrophil / lymphocyte ratio (9.1±12.8 versus 3.5±2.6, p <0.001) were significantly higher in patients with moderate exacerbation. In our study, when the upper limit for serum eosinophilia was 2%, it was found that the rate of patients with less than 2% in patients with moderate exacerbation was significantly higher (78.8 % versus 46.3 %, p <0.001). Conclusion: In COPD exacerbations, serum eosinophil value may be variable, clinical and laboratory findings should be evaluated together to determine the optimal treatment modality in these patients.