Department of Emergency Medicine, Hitit University Erol Olcok Training and Research Hospital, Corum, Turkey.
Department of Emergency Medicine, Kecioren Training and Research Hospital, Ankara, Turkey.
Am J Emerg Med. 2020 Feb;38(2):292-295. doi: 10.1016/j.ajem.2019.05.007. Epub 2019 May 4.
Hyperemesis gravidarum (HG) is defined as severe nausea and vomiting in pregnancy and considered as one of the most frequent causes to emergency department (ED) admissions. Previous research has shown that HG is associated with systemic inflammation, but there have been no prospective studies to explore this link. The objective of this study was to assess the impact of inflammation in HG pathophysiology and to investigate the association between severity of HG and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and CRP in patients who were admitted to ED with nausea and vomiting.
This prospective study has been conducted in a tertiary clinic between 2015 and 2016. A total of 162 patients with <16 weeks gestation with singleton pregnancies and without any chronic diseases enrolled in the study. The study group consisted of 113 patients with HG and the control group included 49 healthy subjects. PUQE Index and VAS were used to evaluate the severity of symptoms.
Demographical data were similar between both groups. The study group demonstrated significantly higher NLR, PLR and CRP levels (NLR 3.39 vs 2.5, p = 0.001; PLR 134.3 vs 111.2, p = 0.005; CRP 0.85 mg/dL vs 0.19 mg/dL, p = 0.001). While NLR and PLR levels were not correlated with severity of HG, CRP levels were associated with severity of disease (p = 0.001) regarding to PUQE index.
NLR and PLR are easily obtained and routinely used diagnostic tools for various inflammatory diseases. Measurement of this markers might provide useful information in HG pathogenesis and diagnosis.
妊娠剧吐（HG）是指妊娠期间严重的恶心和呕吐，被认为是急诊科（ED）入院的最常见原因之一。先前的研究表明，HG 与全身炎症有关，但尚无前瞻性研究探讨这一联系。本研究旨在评估炎症在 HG 病理生理学中的作用，并研究 ED 因恶心和呕吐入院的患者中 HG 严重程度与中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和 C 反应蛋白（CRP）之间的关系。
本前瞻性研究于 2015 年至 2016 年在一家三级诊所进行。共有 162 名孕周<16 周、单胎妊娠且无任何慢性疾病的患者入组本研究。研究组包括 113 名 HG 患者，对照组包括 49 名健康受试者。使用 PUQE 指数和 VAS 评估症状严重程度。
两组患者的人口统计学数据相似。研究组的 NLR、PLR 和 CRP 水平显著升高（NLR 3.39 与 2.5，p=0.001；PLR 134.3 与 111.2，p=0.005；CRP 0.85mg/dL 与 0.19mg/dL，p=0.001）。虽然 NLR 和 PLR 水平与 HG 的严重程度无关，但 CRP 水平与疾病严重程度相关（p=0.001，根据 PUQE 指数）。
NLR 和 PLR 是用于各种炎症性疾病的易于获得和常规使用的诊断工具。这些标志物的测量可能为 HG 发病机制和诊断提供有用信息。
