Kronik hepatit B tanılı hastalarda, RDW, NLR, MPV testlerinin, karaciğer histopatolojisini öngörmedeki tanısal değeri; retrospektif bir çalışma
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hepatit B Virüsü (HBV) insanları enfekte edebilen zarflı bir DNA virüsüdür. Virüsün yüzey antijeninin (HBsAg) serumda 6 ay veya daha uzun süreli pozitif kalması durumu kronik hepatit B enfeksiyonu (KHB) olarak adlandırılmaktadır. KHB'nin klinik takibinde özellikle antiviral tedavi endikasyonunun belirlenmesinde karaciğer biyopsisi altın standart yöntemdir. Karaciğer biyopsisinin invaziv bir girişim olması, ciddi morbidite ve mortalite kaynağı olabilmesi sebepleriyle yeni yöntem arayışları devam etmektedir. Çalışmamızda KHB tanılı hastaların klinik takiplerinde antiviral tedavi endikasyonu belirlenirken rutin tam kan tetkikinde ölçülen MPV, NLR ve RDW değişkenlerinin karaciğer biyopsi sonucunu öngörmedeki değerinin araştırılması amaçlandı. İkincil amaç olarak ise tedavi başlanan hastaların 6. ay takipleri ile aynı parametrelerin tedavi takibindeki değeri araştırıldı. 01.01.2010 ile 01.01.2023 tarihleri arasında hastanemize başvurusu bulunan ve çalışma kriterlerini sağlayan 102 KHB tanılı hasta çalışmaya dahil edildi. Karaciğer biyopsisi sonucuna göre tedavi grubunda 66 hasta kontrol grubunda ise 36 hasta yer aldı. Tüm örneklemin yaş ortalaması 42,9 yıl idi. Tedavi grubunun %62,1'i kontrol grubunun ise %55,6'sı erkek cinsiyette idi. Tedavi ve kontrol grubu cinsiyet ve yaş değişkenleri açısından benzer bulundu (p>0,05). Tedavi ve kontrol grubu arasında MPV, NLR ve RDW değişkenleri açısından fark yoktu (p>0,05). Tedavi grubunun 6 aylık takibinde MPV değerinin azaldığı (p=0,019), NLR değerinin değişmediği (p>0,05) ve RDW değerinin arttığı (p=0,006) bulundu. Ek olarak AST, ALT ve FİB4 değişkenlerinin tedavi grubunda kontrol grubundan daha yüksek olduğu, tedavi alan grubun tedavi sonrasında öncesine göre de daha düşük olduğu belirlendi (p<0,05). Ek olarak bu değerlerin patolojide belirlenen fibrozis ve nekroinflamasyon skorları ile korele olduğu bulundu (p<0,05). KHB hastalarında tam kan tetkiki ile ölçülen MPV, NLR ve RDW değişkenlerinin antiviral tedavi endikasyonunu öngörmede karaciğer biyopsisinin yerini alamayacağı sonucuna varıldı. Bu parametrelerden MPV'nin antiviral tedavi yanıtı takibinde umut vadedici olduğu düşünüldü. AST, ALT ve FİB4 değişkenlerinin ise hem tedavi endikasyonunda hem de tedavi yanıtı takibinde fayda sağlayabileceği öngörüldü.
Hepatitis B Virus (HBV) is an enveloped DNA virus that can infect humans. When the surface antigen of the virus (HBsAg) remains positive in serum for 6 months or longer, it is called chronic hepatitis B infection (CHB). Liver biopsy is the gold standard method in the clinical follow-up of CHB, especially in determining the indication for antiviral treatment. Since liver biopsy is an invasive procedure and can cause serious morbidity and mortality, the search for new methods continues. Our study aimed to investigate the value of MPV, NLR and RDW parameters measured in routine complete blood count test in predicting the liver biopsy result while determining the indication for antiviral treatment in the clinical follow-up of CHB patients. As a secondary outcome, the value of the same parameters in the treatment follow-up was investigated at the 6th months of patients who started treatment. 102 patients diagnosed with CHB who applied to our hospital between 01.01.2010 and 01.01.2023 and met the study criteria were included in the study. According to the liver biopsy evaluations, there were 66 patients in the treatment group and 36 patients in the control group. The mean age of the whole sample was 42,9 years. 62,1% of the treatment group and 55,6% of the control group were male. Treatment and control groups were similar with regard to gender and age variables (p>0,05). There was no difference between the treatment and control groups with regard to MPV, NLR and RDW parameters (p>0,05). In the 6-month follow-up of the treatment group, MPV value decreased (p=0,019), NLR value did not change (p>0,05) and RDW value increased (p=0,006). Additionally, AST, ALT, FIB4 parameters were higher in the treatment group than in the control group, and these parameters were lower after treatment than before treatment (p<0,05). In addition, these parameters were correlated with fibrosis and necroinflammation scores determined in pathology (p<0,05). It was concluded that MPV, NLR and RDW parameters measured with a complete blood count test cannot replace liver biopsy in predicting the indication for antiviral treatment in patients with CHB. Among these parameters, MPV was thought to be promising in the follow-up of antiviral treatment response. AST, ALT and FIB4 parameters were forecasted to be useful both in determining the indication for treatment and in the follow-up of treatment response.
Hepatitis B Virus (HBV) is an enveloped DNA virus that can infect humans. When the surface antigen of the virus (HBsAg) remains positive in serum for 6 months or longer, it is called chronic hepatitis B infection (CHB). Liver biopsy is the gold standard method in the clinical follow-up of CHB, especially in determining the indication for antiviral treatment. Since liver biopsy is an invasive procedure and can cause serious morbidity and mortality, the search for new methods continues. Our study aimed to investigate the value of MPV, NLR and RDW parameters measured in routine complete blood count test in predicting the liver biopsy result while determining the indication for antiviral treatment in the clinical follow-up of CHB patients. As a secondary outcome, the value of the same parameters in the treatment follow-up was investigated at the 6th months of patients who started treatment. 102 patients diagnosed with CHB who applied to our hospital between 01.01.2010 and 01.01.2023 and met the study criteria were included in the study. According to the liver biopsy evaluations, there were 66 patients in the treatment group and 36 patients in the control group. The mean age of the whole sample was 42,9 years. 62,1% of the treatment group and 55,6% of the control group were male. Treatment and control groups were similar with regard to gender and age variables (p>0,05). There was no difference between the treatment and control groups with regard to MPV, NLR and RDW parameters (p>0,05). In the 6-month follow-up of the treatment group, MPV value decreased (p=0,019), NLR value did not change (p>0,05) and RDW value increased (p=0,006). Additionally, AST, ALT, FIB4 parameters were higher in the treatment group than in the control group, and these parameters were lower after treatment than before treatment (p<0,05). In addition, these parameters were correlated with fibrosis and necroinflammation scores determined in pathology (p<0,05). It was concluded that MPV, NLR and RDW parameters measured with a complete blood count test cannot replace liver biopsy in predicting the indication for antiviral treatment in patients with CHB. Among these parameters, MPV was thought to be promising in the follow-up of antiviral treatment response. AST, ALT and FIB4 parameters were forecasted to be useful both in determining the indication for treatment and in the follow-up of treatment response.
Açıklama
Tıp Fakültesi, Enfeksiyon Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji, Infectious Diseases and Clinical Microbiology
