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ORIJINAL ARAŞTIRMA

İnmeli Hastalarda Serum Beta 2-Mikroglobulin Düzeylerinin Fonksiyonel Prognoza Etkisi: Bir Ön Çalışma
Effect of Serum Beta 2-Microglobulin Levels on Functional Prognosis in Stroke Patients: A Preliminary Study
Received Date : 08 Dec 2021
Accepted Date : 06 Oct 2022
Available Online : 24 Oct 2022
Doi: 10.31609/jpmrs.2021-87476 - Makale Dili: EN
J PMR Sci. 2023;26(1):10-7
ÖZET
Amaç: Beta-2 mikroglobulin(β2M) seviyeleri inmede prognozu tahmin etmek için kullanılır. Bugüne kadar, β2M'nin inme sonrası fiziksel iyileşme ile ilişkisini araştıran hiçbir çalışma yoktur. Bu çalışmanın amacı inmeli hastaların β2M düzeyleri ile fonksiyonellik, günlük yaşam aktiviteleri( GYA), morbidite ve mortalite arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: 66 iskemik, 11 hemorajik inme hastası çalışmaya dahil edildi. Tüm hastalar nörorehabilitasyon programı aldı ve 3 ay boyunca takip edildi. Hastaların motor fonksiyonları Brunnstrom inme iyileşme evrelemesi ve GYA Barthel indeksi (BI) kullanılarak değerlendirildi. Bulgular: İskemik ve hemorajik inmeli hastalarda β2M düzeylerinde anlamlı bir fark yoktu(p=0.681). Hastalar yüksek(>1,86 mg/l) ve düşük(≤1,86 mg/l) β2M gruplarına ayrıldığında, iskemik inmeli 59 (%89,4) hasta ve hemorajik inmeli 10 (%90,9) hastada yüksek β2M seviyeleri vardı. . Her iki inme grubunda da Brunnstrom inme iyileşme evrelemesi ve BI değerleri yüksek β2M grubunda genellikle daha düşüktü. Rehabilitasyondan üç ay sonra, iskemik inmeli hastalardan ikisi (%3,4), hemorajik inmeli hastalardan 1'i (%11,1) yeni serebrovasküler olay geçirirken, iskemik inmeli hastalardan üçü (%5,1) ölmüştür. Mortalite ve morbidite gelişen hastaların hepsi β2M>1.86 mg/l grubundaydı. Sonuç: Daha yüksek β2M seviyeleri, inme etiyolojisinden bağımsız olarak kötü fonksiyonel durum ve GYA, inme rekürrensi ve mortalite ile ilişkili görünmektedir. Daha yüksek β2M seviyeleri olan inme hastalarının daha yakın takibi, inme nüksünü ve ölümü önlemede ve dolayısıyla daha iyi fonksiyonel sonuç elde etmede önemli olabilir.
ABSTRACT
Objective: Beta-2 microglobulin (β2M) levels are used to predict prognosis in stroke. To date, there are no studies linking β2M to physical recovery following stroke. The aim of this study was to evaluate the relationship between β2M levels, functionality, activities of daily living(ADLs), morbidity and mortality of patients with stroke. Material and Methods: 66 ischemic, 11 hemorrhagic stroke patients were recruited to the study. All patients received neurorehabilitation and followed up for 3 months. Functionality and ADLs were assessed using the Brunnstrom Stages of Stroke Recovery (BSSR) and Barthel index(BI). Results: There was no significant difference in β2M levels in those with ischemic versus hemorrhagic stroke (p=0.681). When the patients were divided into higher (>1.86 mg/l) and lower (≤1.86 mg/l) serum β2M level groups, 59 (89.4%) patients with ischemic stroke and 10 (90.9%) patients with hemorrhagic stroke had high levels of β2M. In both stroke groups, BSSR and BI values were lower in those with high β2M levels versus those with lower β2M levels. Three months after rehabilitation, two of the patients with ischemic stroke (3.4%) and 1 (11.1%) with hemorrhagic stroke had experienced new cerebrovascular events, three of the patients with ischemic stroke (5.1%) had died. All were in the β2M>1.86 mg/l group. Conclusions: Higher β2M levels appear to be associated with poorer functional status, ADLs, stroke recurrence, and death, regardless of stroke etiology. Closer follow-up of stroke patients with higher β2M levels may be important in preventing stroke recurrence and death and therefore in obtaining better functional outcome.
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