Usability of Hematologic Parameters in Primary Care to Show Disease Activity in Patients with Ankylosing Spondylitis

Authors : Ayşe TOPUZ, İpek TÜRK

Pages : 96-102

Doi:10.21763/tjfmpc.693138

View : 11 | Download : 13

Publication Date : 2020-03-16

Article Type : Research Paper

Abstract :Introduction: Ankylosing spondylitis insert ignore into journalissuearticles values(AS); is a type of chronic inflammatory arthritis resulting in ankylosis of the spine and inflammation of the tendons. In this study, we aimed to investigate the usability of hematologic parameters to determine disease activity in AS patients. Materials and Methods: A total of 65 patients who were previously diagnosed with AS were enrolled retrospectively in the current study. Patients were divided into two groups according to their Bath Ankylosing Spondylitis Disease Activity Index insert ignore into journalissuearticles values(BASDAI); scores. Thirty-one patients who had BASDAI score > 5 served as “active AS” and 34 patients who had BASDAI score < 5 served as “inactive AS”. Patients data including their physical examination findings were recorded. Medications, demographic properties, and laboratory findings of the patients were also recorded. Results: The clinical and demographic features of both groups were comparable. There were no differences between groups according to the use of medications, the duration of AS and the presence of uveitis, enthesopathy, and peripheral arthritis. In laboratory findings, the Erythrocyte Sedimentation Rate insert ignore into journalissuearticles values(ESR);, C-reactive Protein insert ignore into journalissuearticles values(CRP); and Neutrophil/Lymphocyte Ratio insert ignore into journalissuearticles values(NLR); were significantly higher, Mean Platelet Volume insert ignore into journalissuearticles values(MPV); was significantly lower in active AS group than in inactive AS group. In the correlation analysis, BASDAI score had a significantly negative correlation with MPV insert ignore into journalissuearticles values(r=-0.309, p=0.012); and significantly positive correlations with ESR, CRP and N/L values insert ignore into journalissuearticles values(r=0.427, p<0.001, r=0.328, p=0.008 and r=0.316, p=0.010, respectively);. In linear regression analysis , only MPV score was found to be a predictor for AS activity insert ignore into journalissuearticles values(p<0.04);.Conclusion: Mean platelet volume is significantly negative correlated with BASDAI score and could provide a clue for primary care physician which patients who are at high risk for AS activity. Giriş: Ankilozan spondilit insert ignore into journalissuearticles values(AS); omurgada ankiloza yol açan ve tendonlarda inflamasyon oluşturan kronik inflamatuvar artrit çeşididir. Bu çalışmada, AS hastalarında hastalık aktivitesini göstermede hematolojik parametrelerin kullanılabilirliğini araştırdık. Gereç ve Yöntem: Çalışmaya daha önce AS tanısıyla takip edilen toplam 65 hasta retrospektif olarak dahil edildi. Hastalık aktivitesini gösteren Bath Ankylosing Spondylitis Disease Activity Index insert ignore into journalissuearticles values(BASDAI); skoruna göre hastalar iki gruba ayrıldı. BASDAI skoru> 5 olan toplam 31 hasta aktif AS ve BASDAI skoru < 5 olan toplam 34 hasta inaktif AS olarak ayrıldı. Detaylı fizik muayene bulguları da olmak üzere tüm hastaların verileri kaydedildi. Ayrıca hastaların ilaç kullanımları, demografik ve laboratuvar verileri kaydedildi. Bulgular: Her iki grup klinik ve demografik özellikler açısından benzerdi. Ayrıca ilaç kullanım öyküsü, hastalık yaşı, üveit varlığı, entesopati varlığı ve periferik artrit varlığı açısından da iki grup arasında istatiksel fark saptanmadı. Aktif AS grubunda Eritrosit Sedimentasyon Hızı insert ignore into journalissuearticles values(ESH);, C-reaktif Protein insert ignore into journalissuearticles values(CRP); ve Nötrofil/Lenfosit oranı insert ignore into journalissuearticles values(NLR); inaktif AS grubuna göre belirgin olarak yüksek, Ortalama Platelet Hacmi insert ignore into journalissuearticles values(OPH); ise belirgin olarak düşük saptandı. Korelasyon analizinde BASDAI skoru OPH ile belirgin negatif insert ignore into journalissuearticles values(r=-0,309, p=0,012);, ESH, CRP ve NLR ile belirgin pozitif korelasyona sahipti insert ignore into journalissuearticles values(sırasıyla, r=0,427, p<0,001, r=0,328, p=0,008 ve r=0,316, p=0,010);. Bu değişkenler lineer regresyon analizine sokulduğunda sadece OPH’ nin AS hastalık aktivitesini predikte ettiği saptandı insert ignore into journalissuearticles values(p<0,04);. Sonuç: OPH hastalık aktivitesini gösteren BASDAI skoru ile belirgin şekilde negatif ilişkilidir ve birinci basamak aile hekimleri için hangi hastaların AS aktivitesi için yüksek riskli olduğuna dair bir ipucu sağlayabilir.
Keywords : Ankylosing spondylitis, BASDAI score, neutrophyl lymphocyte ratio, mean platelet volume, primary care