Ulus Travma Acil Cerrahi Derg. 2016; 22(2): 163-168 | DOI: 10.5505/tjtes.2015.89346

Nötrofil-lenfosit oraný ve ortalama trombosit hacminin akut apandisitin þiddetini belirlemedeki rolü

Samet Yardýmcý, Mustafa Ümit Uðurlu, Mümin Coþkun, Wafi Attaallah, Þevket Cumhur Yeðen
Marmara Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Ýstanbul

AMAÇ: Perfore akut apandisitin (AA) erken tanýnmasý zor olabilmektedir. Bu çalýþmada, ameliyat öncesi nötrofil-lenfosit oraný (NLR) ve ortalama trombosit hacmi (MPV) ölçümlerinin akut apandisit olgularýnda perforasyonu belirlemedeki rolü araþtýrýldý.
GEREÇ VE YÖNTEM: Dört yüz on üç AA’lý olguya ait geriye dönük veriler ile 100 saðlýklý kontrol çalýþmaya dahil edildi. Akut apandisitli olgulara ait patolojiler flegmonöz apandisit, lokalize peritonitin eþlik ettiði apandisit ve perforasyonlu ve/veya gangrenöz apandisit olgularý olarak üç grupta incelendi. Hastalara ait MPV ve NLR deðerleri gruplar içerisinde ve saðlýklý kontrollere ait sonuçlarla karþýlaþtýrýldý.
BULGULAR: Ortalama MPV deðeri AA grubunda 9.3±8 FL ve saðlýklý kontrollerde 8.5±0.9 Fl idi (p=0.0005). Ortalama MPV deðerleri flegmonöz apandisit grubunda 8.8±5.8, lokalize apandisit grubunda 8.9±5.8 FL ve perforasyonlu ve/veya gangrenöz apandisit grubunda 12.8±9.7 FL olarak saptandý (p=0.005). Perforasyonlu/gangrenöz apandisitli olgularý diðer apandisit olgularýndan ayýrmak için ölçülen eþik MPV deðeri 8.92 Fl idi. Ortalama NPV deðerleri basit apandisit, lokalize apandisit, perforansyonlu/gangrenöz apandisit gruplarýnda sýrasýyla 8.3±5.6, 9.1±6.2 ve 10.6±6.4 olarak saptandý (p=0.023). Perforasyonlu/gangrenöz apandisitli olgularý diðer apandisit olgularýndan ayýrmak için ölçülen eþik NPV deðeri 7.95 idi.
TARTIÞMA: Nötrofil-lenfosit oraný ve MPV ölçümleri akut apandisitin þiddetini belirlemede klinik tanýya yardýmcý olabilir.

Anahtar Kelimeler: Apandisit, lenfosir, nötrofil, ortalama platelet hacmi; prediktif faktörler.

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Neutrophil-lymphocyte ratio and mean platelet volume can be a predictor for severity of acute appendicitis

Samet Yardýmcý, Mustafa Ümit Uðurlu, Mümin Coþkun, Wafi Attaallah, Þevket Cumhur Yeðen
Department Of General Surgery, Marmara University School Of Medicine, Istanbul, Turkey

BACKGROUND: Early diagnosis of perforation in acute appendicitis (AA) allows surgeons to select the most appropriate treatment. The aim of the present study was to determine whether preoperative neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) could predict perforation in AA.
METHODS: Data collected from 413 consecutive patients with AA and 100 healthy controls were analyzed retrospectively. Patients were categorized as having had phlegmonous appendicitis, appendicitis with localized peritonitis, or appendicitis with perforation and/ or gangrene. MPV and NLR values were compared among the control group and the 3 groups of patients with AA.
RESULTS: Means values of MPV were 9.3±8 fL for the patient group and 8.5±0.9 fL for the healthy control group (p=0.0005). Mean values of MPV by patient subgroup were 8.8±5.8 for phlegmonous appendicitis, 8.9±5.8 for localized peritonitis, and 12.8±9.7 for appendicitis with perforation and/or gangrene (p=0.005). Cut-off value of MPV was set at 8.92 to differentiate AA with perforation and/or gangrene from other types of AA. Mean NLRs of patients with phlegmonous appendicitis, appendicitis with localized peritonitis, and appendicitis with perforation and/or gangrene were 8.3±5.6, 9.1±6.2, and 10.6±6.4, respectively; p=0.023. The cut-off value for NLR was set at 7.95 to differentiate AA with perforation and/or gangrene from other types of AA.
CONCLUSION: Both NLR and MPV can be useful in predicting severity of AA.

Keywords: Appendicitis, lymphocyte, mean platelet volume, neutrophil; predictive factors.

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