Tam Kan Sayýmýndaki Parametrelerin Tüberkülozda Biyobelirteç Olarak Klinik Önemi

Amaç: Nötrofil/lenfosit oraný (NLR), kýrmýzý hücre daðýlým geniþliði (RDW), trombosit daðýlým geniþliði (PDW) ve ortalama trombosit hacmi (MPV) göðüs hastalýklarý alanýnda çok az bilinmektedir. Çalýþmanýn amacý, bu yeni belirteçlerin tüberkülozdaki etkisini ve klinik önemini iyi bilinen inflamasyon belirteçleriyle karþýlaþtýrmalý olarak belirlemektir.
Gereç ve Yöntemler: Bir yýllýk sürede, hastanemizde bakteriyolojik olarak kanýtlanmýþ akciðer tüberkülozu tanýsýyla yatmýþ hastalar ve 43 kontrol grubu çalýþmaya dahil edildi. Hastalarýmýzýn tam kan sayýmlarýndan NLR, RDW, MPV, PDW’yi diðer rutin ve yaygýn olarak kullanýlan inflamasyon belirteçleriyle karþýlaþtýrdýk.
Bulgular: Çalýþmaya 112 tüberküloz hastasý ve 43 kontrol hastasý dahil edildi. Gruplar arasý cinsiyet daðýlýmý ve katýlýmcýlarýn yaþ ortalamalarý benzerdi (p=0,48 ve p=0,63). Kontrol ve tüberküloz gruplarý arasýnda PDW haricinde, NLR, RDW, MPV, total lökositler (WBC), C-reaktif protein (CRP) ve eritrosit sedimentasyon hýzý (ESH) istatistiksel olarak farklý bulundu (PDW için p=0,29, geri kalaný için p<0,05). Akciðer grafisinde bilateral infiltrat olan hastalarda (n=67) NLR (7,25 ve 4,47) ve RDW (%17,7 ve %16,4) anlamlý olarak daha yüksekti (p<0,001). NLR ve RDW, tüberküloz ve kontroller arasýnda ayrým yaptý (sýrasýyla AUC=0,930, p<0,001 ve AUC=0,859, p<0,001). NLR, CRP ve ESH ile RDW ise CRP ile iyi korelasyon gösterdi.
Sonuç: Bu çalýþma, göðüs hastalýklarý alanýnda yeni belirteçler olan NLR ve RDW’nin, CRP ve ESH gibi yaygýn inflamasyon belirteçleri ile korele olduðunu ve tüberküloz tanýsýný ve radyolojik olarak ilerlemiþ hastalýðý öngörmede yardýmcý olduðunu gösterdi.

The Clinical Ýmportance of Complete Blood Count Parameters in Tuberculosis as Biomarkers

Objective: The neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW), platelet distribution width (PDW), and mean platelet volume (MPV) are little known in the pulmonary medicine area. The aim of our study was to determine the effect and clinical importance of these new markers in tuberculosis (TB) in comparison with wellknown inflammation markers.
Material and Methods: Patients with bacteriologic evidence for pulmonary TB who were admitted to our hospital for 1 year period as inpatients and 43 controls were included into the study. We compared NLR, RDW, MPV, and PDW from complete blood counts of our patients with other routine and commonly-used inflammation markers.
Results: The study comprised 112 patients with TB and 43 control patients. The distribu-tion of sex between groups and the mean ages of participants were similar (p=0.48 and p=0.63). With the exception of PDW, NLR, RDW, MPV, total leukocytes (WBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) was found statistically different between the control and TB groups; p=0.29 for PDW, p<0.05 for the rest. In patients with bilateral infiltrates (n=67) on chest X-ray, NLR (7.25 vs. 4.47) and RDW (17.7% vs. 16.4%) were significantly higher (p<0.001 for both parameters). NLR and RDW made discrimination between TB and controls (AUC=0.930, p<0.001 and AUC=0.859, p<0.001, respectively). NLR correlated well with CRP and ESR, and RDW correlated with CRP.
Conclusion: This study showed that NLR and RDW, as recent markers in pulmonary medicine, were correlated with common inflammation markers such as CRP and ESR, and helped to predict TB diagnosis and radiologically-advanced disease.