Akut kolesistitte pentraxin 3 düzeyinin prognostik önemi

AMAÇ: Safra taþý hastalýðý geliþmiþ ülkelerde sýk görülen bir sorundur. Eriþkinlerin en az %10’unda safra taþý vardýr. Safra taþý olan insanlarýn %40–60’ý semptomsuz klinik seyir gösterirken, semptomlu kolelitiazisi olan olgularýn çoðunda da semptomsuz bir dönem bulunur. Semptomlu safra taþlarýnýn %20’si akut kolesistit tablosu ile acil servislere baþvurur. Bu çalýþmada, akut kolesistitli olgularda, pentraksin 3 (PTX3) düzeylerin komplikasyonlar ve prognoz üzerindeki tanýsal deðerini belirlemeyi ve akut kolesistit olgularýnda morbidite ve mortalite oranlarýný azaltmayý amaçladýk.
GEREÇ VE YÖNTEM: Bu çalýþma Atatürk Üniversitesi Týp Fakültesi Genel Cerrahi Servisi’nde Eylül 2012–Ocak 2014 tarihleri arasýnda akut taþlý kolesistit tanýsý konulup ameliyat edilen hastalar üzerinde yapýldý. Çalýþmaya yaþlarý 18’den büyük, klinik ve radyolojik olarak akut taþlý kolesistit tanýsý konmuþ 45 hasta (Grup I) ve 18 yaþ üstü 45 saðlýklý (Grup II) kiþi alýndý. Olgular randomize olarak seçildi.
BULGULAR: Çalýþmamýzda plazma PTX3 düzeyinin hasta grubunda ve morbidite geliþen hastalarda yüksek olmakla birlikte istatisitiksel olarak anlamlý deðildi. Pentraksin 3 deðerlerinin ileri yaþ hastalarda anlamlý olarak arttýðý saptandý (p<0.05). Ayrýca hastanede yatýþ süreli karþýlaþtýrýldýðýnda PTX3’ün hastanede daha uzun süre yatan hastalarda daha yüksek olduðu belirlendi (p<0.05).
TARTIÞMA: Pentraksin 3 düzeyleri akut kolesistitli hastalarda deðerlendirilen tüm parametrelerde yüksek bulundu. Bu yüzden PTX3 düzeyleri akut kolesistitte taný ve prognoz tahmininde deðerli bir gösterge olabilir.

Prognostic importance of pentraxin 3 levels in acute cholesistitis

BACKGROUND: Cholelithiasis is a frequently encountered problem in developed countries. Gallstone is present in at least 10% of the adults. While 40–60% of people with gallstones manifest an asymptomatic clinical course, in most of the cases with symptomatic cholelithiasis, there is also an asymptomatic period. 20% of the patients with symptomatic gallstones are admitted to emergency services with clinical features of acute cholecystitis. In this study, our aim was to evaluate the diagnostic value of pentraxin 3 on complications and prognosis and also to reduce the morbidity and mortality rates in cases with acute cholecystitis.
METHODS: This study was conducted on patients diagnosed with acute calculous cholecystitis and operated on between September 2012 and January 2014, in the Department of General Surgery of Atatürk University Medical Faculty. Forty-five patients with ages above 18, who were clinically and radiologically diagnosed with acute calculous cholecystitis (Group I) and 45 healthy people, older than 18 (Group II) were included into the study. Patients were randomly selected.
RESULTS: In our study, although the plasma pentraxin 3 (PTX3) levels were increased in the patient group and also in patients who developed morbidity, this was not statistically significant. PTX3 values were determined to be significantly increased in older patients (p<0.05). Moreover, when the duration of hospital stays were compared, PTX3 was found to be significantly higher in patients hospitalized for longer periods (p<0.05).
CONCLUSION: PTX3 levels were found to be elevated in all evaluated parameters in patients with acute cholecystitis. Therefore, PTX3 level may be a valuable indicator in diagnosis and also in predicting prognosis.