Öz
Giriş
DKA, tip 1 diyabette erken dönemde ortaya çıkan, hayatı tehdit eden bir hastalıktır. Bazı merkezlerde tanısal kaynak eksiklikleri, DKA tanısının gecikmesine neden olabilir. Kronik hastalıklarda, hematolojik inflamatuar göstergelere olan ilgi artmaktadır. Bu parametrelerin DKA tanısı ve şiddeti üzerindeki etkisi, bu kesitsel araştırmanın amacını oluşturmuştur.
Gereç ve Yöntem
Çalışma, tek bir merkezden 54 DKA tanısı almış T1DM çocukları ve 50 sağlıklı kontrolü içermektedir. Tam kan sayımından, SII, SIRI, NLR ve PLR değerleri hesaplanmış, Platecrit, MPV ve PDW değerleri kaydedilmiştir. DKA, ISPAD kriterlerine göre hafif, orta veya şiddetli olarak üç gruba ayrılmıştır. Ardından, enfekte olmayan T1DM hastalarının bağımsız DKA prediktörleri analiz edilmiştir. Değişken tanısal performans, ROC eğrisi analizi ile belirlenmiştir. Çoklu lojistik regresyon analizi, tüm önemli parametreleri incelemiştir.
Bulgular
SII, NLR ve Platecrit, DKA şiddetini anlamlı şekilde öngörmektedir (X2[3]SII=2973.23, X2[3]PCT =0,063, X2[3]NLR=93.29; pSII: 0,0001, pPCT: 0,0001, pNLR: 0,01). SII, şiddetli asidoz ve T1DM tanısını tanımada en iyi belirteçti ve %94,44 hassasiyet ve %81,48 özgüllük ile [AUC: 0,925 ve 0,875] en yüksek performansı gösterdi. Bu, DKA çocuklarında yapılan ilk SII/SIRI araştırmalarından biridir
Sonuç
SII, NLR ve Platecrit, DKA şiddetini doğru şekilde tahmin edebilir, ancak SII, DM tanısı ve şiddetli asidozun tanınması için en etkili belirteçtir. Kaynakların sınırlı olduğu ortamlarda, SII şiddetli asidoz değerlendirmesi için kan gazı testlerine alternatif olarak uygun bir seçenek olabilir.
Anahtar Kelimeler: Diyabetik ketoasidoz, nötrofil-lenfosit oranı, plateletcrit, platelet-lenfosit oranı, sistemik immün-enflamasyon indeksi, tip 1 diyabetes mellitus
Kaynakça
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