Perihepatik lenfadenopati kronik hepatit b izleminde prognostik bir kriter olabilir mi?
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Date
2005-02-21
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Uludağ Üniversitesi
Abstract
Kronik B Hepatiti (KBH) tanısı alan hastalarda ultrasonografik olarak saptanan perihepatik LAP’nin antiviral tedavi ile gösterdiği değişimin KBH taşıyıcıları ile karşılaştırmalı olarak araştırılması planlandı. KBH tanısı alan 39 hasta ve KBH taşıyıcısı olan 23 hastada abdominal US incelemesi “e”antijeni(Ag) serokonversiyonu sonrası eş zamanlı olarak tekrarlandı. Perihepatik LAP boyutundaki değişimin ALT düzeyi, HBe Ag varlığı, HBV-DNA negatifleşmesiyle ilişkisi araştırıldı. KBH tanısı alan 39 hastadan 22’sinde (%56) US ile perihepatik LAP saptandı. 19 hastaya interferon tedavisi uygulandı. Bu hastalardan tedaviye yanıt veren 16’sında ve spontan serokonversiyon gösteren 1 hastada lenf nodu boyutlarında anlamlı küçülme saptandı (p<0.01). Tedaviye yanıt vermeyen 3 hastada lenf nodu boyutlarında anlamlı değişiklik olmadığı görüldü. Lenf nodu boyutundaki küçülmenin hastaların ALT düzeylerindeki düşme ile paralellik gösterdiği bulundu (p<0.05). KBH taşıyıcısı olan 23 hastanın 5’inde (% 21.7) perihepatik LAP saptandı. Bu hastaların 1 yıllık izleminde LAP boyutlarında anlamlı değişiklik saptanmadı (p>0.05).Perihepatik lenf nodu boyutunda küçülmenin interferon tedavisine iyi yanıtın veya viral klirensin indirekt bir göstergesi olarak kabul edilebileceği düşünüldü.
The purpose of this study is to evaluate the change of perihepatic Iymph node size after antiviral therapy in a group of patients with chronic B hepatitis and to compare this data with serum ALT and HBV-DNA levels. Sixty two patients were studied; including 39 with chronic B hepatitis and 23 chronic HBV carrier. The presence of perihepatic lymph nodes was investigated using ultrasound before and after antiviral therapy and was compared with serum ALT and HBV-DNA levels as well as the presense of the Hbe antigen. Lymph nodes were detected in 22 patients with chronic B hepatitis and 5 chronic HBV carriers. Antiviral therapy was applied to 19 patients of whom the regression of lymph node size was found after response to the therapy (p<0.05). There was no differences in the carrier group (p>0.05). A positive corelation between regression of lymph node size and reduction of in ALT levels in the patient group with chronic hepatitis B was detected. As a conculusion, it is suggested that the regression of the perihepatic lymph node size may be used as an indicator of success of antiviral therapy.
The purpose of this study is to evaluate the change of perihepatic Iymph node size after antiviral therapy in a group of patients with chronic B hepatitis and to compare this data with serum ALT and HBV-DNA levels. Sixty two patients were studied; including 39 with chronic B hepatitis and 23 chronic HBV carrier. The presence of perihepatic lymph nodes was investigated using ultrasound before and after antiviral therapy and was compared with serum ALT and HBV-DNA levels as well as the presense of the Hbe antigen. Lymph nodes were detected in 22 patients with chronic B hepatitis and 5 chronic HBV carriers. Antiviral therapy was applied to 19 patients of whom the regression of lymph node size was found after response to the therapy (p<0.05). There was no differences in the carrier group (p>0.05). A positive corelation between regression of lymph node size and reduction of in ALT levels in the patient group with chronic hepatitis B was detected. As a conculusion, it is suggested that the regression of the perihepatic lymph node size may be used as an indicator of success of antiviral therapy.
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Keywords
Kronik B hepatiti, Lenf nodu, Ultrasonografi, Chronic hepatitis B, Lymph node, Ultrasound
Citation
Özkan, T. B. vd. (2005). ''Perihepatik lenfadenopati kronik hepatit b izleminde prognostik bir kriter olabilir mi?''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 31(3), 143-145.