Akut inme tanısı olan hastalarda kalp tipi yağ asidi bağlayıcı protein düzeyinin nörolojik skorlama sistemleri ve inme doku volümleri ile karşılaştırılması
Yükleniyor...
Dosyalar
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: İnme ile başvuran hastalarda tanıda, prognozun belirlenmesinde ya da tedavinin monitörize edilmesinde kullanılabilecek belirteçlere ihtiyaç vardır. Kalp tipi yağ asidi bağlayıcı protein (Heart-type fatty acid binding protein (h-FABP)) küçük bir sitoplazmik proteindir ve yağ asidi metabolizmasında yağ asidlerinin oksidasyonunda rol alır. Özellikle iskemik inmede serum h-FABP düzeylerinin bir belirteç olarak kullanımı ile ilgili son dönemde çalışmalar yapılmaktadır. Bu çalışmanın amacı acil servise inme ile başvuran hastalarda prospektif olarak ölçülen serum h-FABP düzeylerinin nörolojik skorlama sistemleri ve inme volümleri ile ilişkisinin belirlenmesidir. Gereç ve Yöntem: Bu çalışmaya Ekim 2014 - Şubat 2015 tarihleri arasında Selçuk Üniversitesi Tıp Fakültesi Hastanesi Acil Servisine semptomların başlangıcından itibaren ilk 24 saat içinde başvuran ve inme tanısı alan 105 hasta dahil edildi. Ayrıca, benzer yaş grubunda, bilinen başka ek hastalığı olmayan 60 kişi de kontrol grubu olarak alındı. Hastaların demografik özellikleri, şikayetleri, biyokimyasal değerleri ve h-FABP düzeyleri kaydedildi. Ayrıca tüm hastaların radyolojik görüntülerinden inme volümleri hesaplandı. Bulgular: Kontrol grubu ortalama h-FABP düzeyleri 2519.58±3423.67 ng/ml, hasta grubunda ise 5954.71±6108.92 ng/ml olarak saptandı ve her iki grup arasında anlamlı farklılık vardı (p=0.001). İskemik inmesi olan hastaların 17 tanesi, hemorajik inmesi olanların ise 6 tanesi öldü. İskemik inmesi olan hasta grubunda ölen hastaların ortalama h-FABP düzeyleri sağ kalan hastaların h-FABP düzeyleri ile karşılaştırıldığında (sırasıyla 9702.64±8196,67 ve 5038.97±4733.16 ng/ml) anlamlı bir farklılık saptandı (p=0.03). Hemorajik inmesi olan hasta grubunda ölen hastaların ortalama h-FABP düzeyleri sağ kalan hastalarınki ile karşılaştırıldığında (sırasıyla 10178.63±9009.86 ng/ml ve 4721.43±4079.80 ng/ml) yine istatistiksel olarak anlamlı bir farklılık saptandı (p=0.01). Hemorajik inmesi olan hastaların beyin tomografisindeki ortalama inme volümleri 39.78±57.69 iken iskemik inmesi olan hastaların MR'deki ortalama stroke volümü 49.63±73.69 olarak belirlendi (p=0.52). Hem hemorajik hem de iskemik inmesi olan hastaların inme volümleri ile h-FABP düzeyleri arasında istatistiksel anlamlı bir korelasyon saptandı (sırasıyla p=0.027, t=0.51 ve p=0.008, t=0.27). Sonuç: Akut inme semptomları ile acil servise ilk 24 saat içinde başvuran hastalarda yüksek serum h-FABP düzeyleri iskemik ve hemorajik inme tanısını destekleyen, ayrıca yatış yapılarak takip edilen bu hasta gruplarında hastane mortalitesini gösteren önemli bir belirteç olabilir.
Aim: New markers are required in diagnosis, evaluation of prognosis and monitorization of treatment among stroke patients. Heart-type fatty acid binding protein (h-FABP) is a small cytoplasmic protein that plays a role in fatty acid oxidation. There are some studies reporting that h-FABP levels may be used as a biomarker in especially ischemic stroke. The aim of this study was to determine the association of h-FABP levels with neurologic scoring systems and stroke volumes among stroke patients Material and Method: Totally 105 patients, admitted to the Selçuk University Medical School Hospital, Emergency Medicine Department with the stroke complaints for less than 24 hours and diagnosed with stroke were included in this study. Moreover, 60 age and gender matched healthy cases were also included as control group. Demographic data, complaints, biochemical values and h-FABP levels of all patients are recorded; radiologically stroke volumes are computed for all patients. Results: The mean h-FABP levels of patients and control cases were 5954.71 ± 6108.92 ng/ml and 2519.58± 3423.67 ng/ml, respectively and the difference was statistically significant (p=0.001). Seventeen of cases with ischemic stroke and 6 of hemorrhagic stroke cases were expired. In comparison of mean h-FABP levels of living and expired ischemic stroke cases (respectively, 9702,64 ± 8196,67 and 5038,97 ± 4733,16 ng/ml; p= 0.03) the difference was statistically significant. Similarly, in comparison of mean h-FABP levels of living and expired hemorrhagic stroke cases (respectively10178,63 ± 9009,86 ng/ml and 4721,43 ± 4079,80 ng/ml; p=0.01) the difference was statistically significant. The mean stroke volume of patients with hemorrhagic stroke in computed tomography was 39.78 ± 57.69 and the mean stroke volume of patients with ischemic stroke in magnetic resonance was 49.63 ± 73.69 (p:0.52). There was a statistically significant correlation between stroke volume and h-FABP levels of both hemorrhagic and ischemic stroke patients (respectively, (p:0.027, t:0.51) and (p:0.008, t:0.27)). Conclusion: High serum h-FABP levels may be used as a marker supporting the diagnosis of hemorrhagic and ischemic stroke in patients admitted to the emergency department with stroke complaints in first 24 hours ofcomplaints. Moreover, it may be an important marker showing in-hospital mortality among hospitalized patients with acute stroke.
Aim: New markers are required in diagnosis, evaluation of prognosis and monitorization of treatment among stroke patients. Heart-type fatty acid binding protein (h-FABP) is a small cytoplasmic protein that plays a role in fatty acid oxidation. There are some studies reporting that h-FABP levels may be used as a biomarker in especially ischemic stroke. The aim of this study was to determine the association of h-FABP levels with neurologic scoring systems and stroke volumes among stroke patients Material and Method: Totally 105 patients, admitted to the Selçuk University Medical School Hospital, Emergency Medicine Department with the stroke complaints for less than 24 hours and diagnosed with stroke were included in this study. Moreover, 60 age and gender matched healthy cases were also included as control group. Demographic data, complaints, biochemical values and h-FABP levels of all patients are recorded; radiologically stroke volumes are computed for all patients. Results: The mean h-FABP levels of patients and control cases were 5954.71 ± 6108.92 ng/ml and 2519.58± 3423.67 ng/ml, respectively and the difference was statistically significant (p=0.001). Seventeen of cases with ischemic stroke and 6 of hemorrhagic stroke cases were expired. In comparison of mean h-FABP levels of living and expired ischemic stroke cases (respectively, 9702,64 ± 8196,67 and 5038,97 ± 4733,16 ng/ml; p= 0.03) the difference was statistically significant. Similarly, in comparison of mean h-FABP levels of living and expired hemorrhagic stroke cases (respectively10178,63 ± 9009,86 ng/ml and 4721,43 ± 4079,80 ng/ml; p=0.01) the difference was statistically significant. The mean stroke volume of patients with hemorrhagic stroke in computed tomography was 39.78 ± 57.69 and the mean stroke volume of patients with ischemic stroke in magnetic resonance was 49.63 ± 73.69 (p:0.52). There was a statistically significant correlation between stroke volume and h-FABP levels of both hemorrhagic and ischemic stroke patients (respectively, (p:0.027, t:0.51) and (p:0.008, t:0.27)). Conclusion: High serum h-FABP levels may be used as a marker supporting the diagnosis of hemorrhagic and ischemic stroke in patients admitted to the emergency department with stroke complaints in first 24 hours ofcomplaints. Moreover, it may be an important marker showing in-hospital mortality among hospitalized patients with acute stroke.
Açıklama
Anahtar Kelimeler
İskemik inme, Hemorajik inme, Prognoz, Ischemic stroke, Hemorrhagic stroke, Prognosis
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Çağlayan, F. (2015). Akut inme tanısı olan hastalarda kalp tipi yağ asidi bağlayıcı protein düzeyinin nörolojik skorlama sistemleri ve inme doku volümleri ile karşılaştırılması. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
