Povezanost između indeksa C-reaktivni protein-albumin-limfociti (CALLY) i cerebralnog edema kod bolesnika sa akutnim ishemijskim moždanim udarom
Sažetak
Uvod/Cilj. Postoji povezanost između edema mozga i zapaljenja koje se može pojaviti u moždanom udaru. Cilj rada bio je da se utvrdi povezanost između indeksa C-reaktivni protein-albumin-limfociti (C-reactive protein-albumin-lymphocyte – CALLY) i posledičnim edemom mozga kod bolesnika sa moždanim udarom. Metode. Retrospektivnom studijom obuhvaćeni su bolesnici stari 18 ili više godina, koji su se javili u hitnu pomoć od januara 2021. do decembra 2023. godine i bili primljeni na neurologiju/odeljenje intenzivne nege sa dijagnozom moždanog udara. U istraživanje su bili uključeni sledeći hematološki parametri: zbirni imunsko-zapaljenski količnik (pan-immune-inflammation value – PIV), indeks sistemskog zapaljenskog odgovora (systemic inflammatory response index – SIRI), sistemski imunsko-zapaljenski indeks (systemic immune-inflammation index – SII) i indeks CALLY. Ovi parametri izračunati su iz uzoraka krvi bolesnika uzetih prilikom prijema, a neurohirurzi su procenili razvoj cerebralnog edema i potrebu za dekompresijom. Parametri su upoređivani između dve grupe bolesnika: onih kod kojih je postojala potreba dekompresijom, hirurška grupa (surgical group – SG) i onih bez takve potrebe, nehirurška grupa (nonsurgical group – NSG). Rezultati. Istraživanjem je obuhvaćeno ukupno 274 bolesnika, od kojih je 189 (68,90%) bilo u NSG, a 85 (31,10%) u SG. Utvrđeno je da je indeks CALLY bio značajno viši kod bolesnika NSG u odnosu na SG (16,47 vs. 0,79; p < 0,001). Nivoi SIRI i SII bili su značajno viši kod bolesnika SG u odnosu na NSG (p < 0,001 i p = 0,001, redom). Nivo PIV bio je takođe značajno viši kod bolesnika SG u odnosu na NSG (p < 0,001). Na cut-off vrednosti 4,06, utvrđena je senzitivnost 69,40% i specifičnost 83,00% CALLY indeksa Zaključak. Indeks CALLY je lako dostupan marker koji je jednostavno izračunati, kojim se može predvideti potreba za dekompresijom koja se može razviti kod bolesnika sa moždanim udarom.
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