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
Şükran GÜZELa, Selin ÖZENa, Hüma BÖLÜK ŞENLİKÇİb, Seyhan SÖZAYa
aDepartment of Physical Medicine and Rehabilitation, Başkent University Faculty of Medicine, Ankara, Türkiye
bClinic of Physical Medicine and Rehabilitation, Ankara City Hospital, Hospital, Ankara, Türkiye
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.
Anahtar Kelimeler: İnme; beta 2-mikroglobulin; günlük yaşam aktiviteleri; rehabilitasyon
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.
Keywords: Stroke; beta 2-microglobulin; activity of dailiy living; rehabilitation
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