Acil serviste akut pankreatit tanısı konulan hastalarda pankreatik taş protein ve D vitamini düzeylerinin hastalığın prognozu arasındaki ilişki
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Tarih
2024
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Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Acil serviste tanısı konulan akut pankreatit vakalarında D vitamini ve pankreatik taş protein düzeyleri ölçülmüştür. D vitamini eksikliği ve akut pankreatit arasındaki ilişki araştırılmıştır. Pankreatik taş proteinin akut pankreatit tanısında belirteç olarak rolü ve hastalığının prognozu ile ilişkisi sorgulanmıştır. Yüksek pankreatik taş protein düzeylerinin, akut pankreatitin mortalitesi üzerindeki anlamını araştırmak amaçlanmıştır. Gereç ve Yöntem: Selçuk Üniversitesi Tıp Fakültesi Hastanesi Acil Servisine Mart 2022 ile Eylül 2022 tarihleri arasında başvuran ve Revize Atlanta Sınıflandırmasına göre akut pankreatit tanısı konulan 82 hasta prospektif olarak incelemeye alınmıştır. Hasta grubuna ek olarak akut pankreatit dışındaki sebeplerle kliniğimize gelen 76 adet gönüllü de çalışmamıza dahil edilmiştir. Hasta ve gönüllü grubu 18 yaş üzerindeki bireylerden seçilmiştir. Hastaların özgeçmişleri, vital değerleri, laboratuvar bulguları, görüntüleme tetkikleri kaydedilmiştir. Yoğun bakım skorlamaları hesaplanıp yatış süreleri ve akıbetleri takip edilmiştir. Hasta ve kontrol gruplarındaki PSP ve D vitamini düzeyleri mevcut veriler ile karşılaştırılmıştır. İstatistiksel analizler SPSS 21.0 (IBM Inc, Chicago, IL, USA) programı kullanılarak yapılmıştır. Elde edilen veriler istatistik analizler yapılarak birbirleri ile kıyaslanmıştır. Bulgular: Yapılan incelemede PSP artışlarının akut pankreatit mortalitesi üzerinde zayıf düzeyde anlamlı bir etkisinin olduğu görülmüştür (-2LL=15,595 R2 Nagelkerke=0,187 p=0,047). PSP'nin istatistiksel olarak anlamlı bir tanısal özelliği görülmemiştir. D vitaminin 12,45 ng/ml cut-off değerinde prediktif özelliğinin olduğu (p=0,04), fakat marker özelliklerinin klinik kullanım açısından kabul edilebilir düzeyde olmadığı görülmüştür (AUC=0,596 senstivite=%56,1 spesifite=%56,6). Sonuç: Akut pankreatitin başvuru anında ciddiyetini belirlemek hem agresif tedavilerin uygulanması hem de prognoz açısından çok önemlidir. Yüksek PSP seviyeleri varlığında akut pankreatitin daha mortal olabileceği hipotezi gelecekte başka araştırmalara imkân vermektedir. D vitamininin belirteç olarak kullanımı kabul edilebilir düzeyde bulunmamıştır. Aksi yönden bakılırsa akut pankreatitte D vitamini eksikliğinin de görülebileceği akılda tutulmalıdır.
OBJECT: Vitamin D and pancreatic stone protein levels were measured in acute pancreatitis cases diagnosed in the emergency department. The relationship between vitamin D deficiency and acute pancreatitis has been investigated. The role of pancreatic stone protein as a marker in the diagnosis of acute pancreatitis and its relationship with the prognosis of the disease has been questioned. It was aimed to investigate the significance of high pancreatic stone protein levels on the mortality of acute pancreatitis. MATERIAL AND METHODS: Eighty-two patients who applied to the Emergency Department of Selcuk University Medical Faculty Hospital between March 2022 and September 2022 and were diagnosed with acute pancreatitis according to the Revised Atlanta Classification were prospectively evaluated. In addition to the patient group, 76 volunteers who came to our clinic for reasons other than acute pancreatitis were also included in our study. The patient and volunteer group was selected from individuals over the age of 18. The patients' medical histories, vital values, laboratory findings, and imaging tests were recorded. Intensive care scores were calculated and hospitalization times and outcomes were followed. PSP and vitamin D levels in the patient and control groups were compared with existing data. Statistical analyzes were performed using SPSS 21.0 (IBM Inc, Chicago, IL, USA). The obtained data were compared with each other by statistical analysis. RESULTS: The analysis showed that PSP increases had a weakly significant effect on acute pancreatitis mortality (-2LL=15.595 R2 Nagelkerke=0.187 p=0.047). No statistically significant diagnostic feature of PSP was observed. It was observed that vitamin D had predictive properties at a cut-off value of 12.45 ng/ml (p = 0.04), but its marker properties were not at an acceptable level for clinical use (AUC = 0.596, sensitivity = 56.1%, specificity = 56.6%). CONCLUSION: Determining the severity of acute pancreatitis at the time of presentation is very important for both the application of aggressive treatments and prognosis. The hypothesis that acute pancreatitis may be more mortal in the presence of high PSP levels allows for further research in the future. The use of vitamin D as a marker was not found to be at an acceptable level. On the contrary, it should be kept in mind that vitamin D deficiency can also be seen in acute pancreatitis.
OBJECT: Vitamin D and pancreatic stone protein levels were measured in acute pancreatitis cases diagnosed in the emergency department. The relationship between vitamin D deficiency and acute pancreatitis has been investigated. The role of pancreatic stone protein as a marker in the diagnosis of acute pancreatitis and its relationship with the prognosis of the disease has been questioned. It was aimed to investigate the significance of high pancreatic stone protein levels on the mortality of acute pancreatitis. MATERIAL AND METHODS: Eighty-two patients who applied to the Emergency Department of Selcuk University Medical Faculty Hospital between March 2022 and September 2022 and were diagnosed with acute pancreatitis according to the Revised Atlanta Classification were prospectively evaluated. In addition to the patient group, 76 volunteers who came to our clinic for reasons other than acute pancreatitis were also included in our study. The patient and volunteer group was selected from individuals over the age of 18. The patients' medical histories, vital values, laboratory findings, and imaging tests were recorded. Intensive care scores were calculated and hospitalization times and outcomes were followed. PSP and vitamin D levels in the patient and control groups were compared with existing data. Statistical analyzes were performed using SPSS 21.0 (IBM Inc, Chicago, IL, USA). The obtained data were compared with each other by statistical analysis. RESULTS: The analysis showed that PSP increases had a weakly significant effect on acute pancreatitis mortality (-2LL=15.595 R2 Nagelkerke=0.187 p=0.047). No statistically significant diagnostic feature of PSP was observed. It was observed that vitamin D had predictive properties at a cut-off value of 12.45 ng/ml (p = 0.04), but its marker properties were not at an acceptable level for clinical use (AUC = 0.596, sensitivity = 56.1%, specificity = 56.6%). CONCLUSION: Determining the severity of acute pancreatitis at the time of presentation is very important for both the application of aggressive treatments and prognosis. The hypothesis that acute pancreatitis may be more mortal in the presence of high PSP levels allows for further research in the future. The use of vitamin D as a marker was not found to be at an acceptable level. On the contrary, it should be kept in mind that vitamin D deficiency can also be seen in acute pancreatitis.
Açıklama
Anahtar Kelimeler
D Vitamini, Pankreatik Taş Protein, Acute Pancreatitis, Vitamin D, Pancreatic Stone Protein, Akut Pankreatit
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
Yıldırım, O. (2024). Acil serviste akut pankreatit tanısı konulan hastalarda pankreatik taş protein ve D vitamini düzeylerinin hastalığın prognozu arasındaki ilişki. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
