Kronik hepatit c tanılı hastalarda karaciğer fibrozisi ile demografik bulgular arasındaki ilişkinin belirlenmesi
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Date
2012
Authors
Yoğurt, İsmail
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Hepatit C virüs (HCV) enfeksiyonu dünyada kronik karaciğer hastalıklarının ana nedenlerinden biridir. Yaklaşık 130-210 milyon kişin veya dünya nüfusunun %3'ünün HCV ile kronik olarak enfekte olduğu tahmin edilmektedir. HCV enfeksiyonu hem akut hem de kronik hepatite neden olabilir. Akut hepatit C atağından sonra kronik enfeksiyon riski yüksektir. Yaş, etnik köken, cinsiyet, HCV-ilişkili sellüler immün cevap, viral çeşitlilik, alkol kullanımı, obezite, insülin direnci, viral koenfeksiyon, çevresel faktörler ve coğrafyayı içeren çeşitli faktörler hastalarda hastalık progresyonunun önemli belirleyicileri olabilir.Hastaların hem Knodell hem de İshak evreleme sistemi ile fibrozis ve histolojik aktivite indeksi (HAİ) skorları belirlendi. Bu skorlar ile hastaların demografik bulguları, alışkanlıkları, yandaş hastalıkları ve basit laboratuvar bulguları arasındaki ilişki araştırıldı.Bu çalışmaya 60 kadın 41 erkek toplam 101 kronik hepatit C (KHC)'li hasta alındı. Hastaların ortalama yaşı 50 ± 11.82 yıl idi. Hastaların fibrozis skorları ile yaş, vücut kitle indeksi (VKİ), tip 2 diyabetes mellitus (T2DM), hipertansiyon, HOMA-İR (Homeostasis Model Assessment-İnsulin Resistance), koagulasyon parametreleri, karaciğer fonksiyon testleri ve HCV RNA (Hepatit C Virüsü RiboNükleik Asit) düzeyleri arasında pozitif, trombosit sayısı ve albumin düzeyleri ile negatif anlamlı korelasyon saptandı (her biri için; p < 0.05). HAİ skorları ile yaş, VKİ, T2DM, koagulasyon parametreleri, karaciğer fonksiyon testleri arasında pozitif, trombosit sayısı ve albumin düzeyleri ile negatif anlamlı korelasyon saptandı (her biri için; p < 0.05). Fibrozis ve HAİ skorları ile cinsiyet, hafif-orta düzeyde sigara ve alkol kullanımı, hiperlipidemi, kronik akciğer hastalığı, böbrek fonksiyon testleri, lipit parametreleri arasında anlamlı korelasyon saptanmadı.Yaş, VKİ, T2DM, hipertansiyon ve HOMA-İR birlikte değerlendirildiğinde metabolik sendromun KHC tanılı hastalarda hastalık progresyonu açısından etkili olabileceği kanaatine varıldı. Bu nedenle, tüm KHC'li hastalarda metabolik sendromun araştırılması gerekmektedir.
Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. It is estimated that approximately 130-210 million individuals, or 3% of the world population, are chronically infected with HCV. Infection with the HCV can result in both acute and chronic hepatitis. The risk of chronic infection after an acute episode of hepatitis C is high. Several factors may be important determinants of disease progression in patients, including age, ethnic background, gender, HCV-specific cellular immune response, viral diversity, alcohol use, obesity, insulin resistance, viral co-infection, environmental factors and geography.Fibrosis and histological activity index (HAI) scores of patients were determined with both Knodell?s and İshak?s staging systems. The relationship between these scores and demographic findings, habits, concomitant diseases, and basic laboratory findings of patients was investigated.In this study, 60 women and 41 men, a total of 101 patients with chronic hepatitis C (CHC) were included. The mean age of patients was 50 ± 11.82 years. Significant positive correlations were found between fibrosis scores with age, body mass index (BMI), type 2 diabetes mellitus (T2DM), hypertension, HOMA-IR (Homeostasis Model Assessment-Insulin Resistance), coagulation parameters, hepatic function tests and HCV RNA levels. Significant negative correlations were found between fibrosis scores with platelet count and albumin levels (for each; p < 0.05). Significant positive correlations were found between HAI scores with age, BMI, T2DM, coagulation parameters, and hepatic function tests. Significant negative corelations were found between HAI scores with platelet count and albumin levels (for each; p < 0.05). There were no significant correlations between fibrosis and HAI scores with gender, mild-moderate smoking and alcohol use, hyperlipidemia, chronic lung diseases, renal function tests and lipid parameters.It is concluded that metabolic syndrome can be effective in terms of disease progression in patients with CHC, when the age, BMI, T2DM, hypertension and HOMA-IR considered together. Metabolic syndrome must be investigated in all patients with CHC.
Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. It is estimated that approximately 130-210 million individuals, or 3% of the world population, are chronically infected with HCV. Infection with the HCV can result in both acute and chronic hepatitis. The risk of chronic infection after an acute episode of hepatitis C is high. Several factors may be important determinants of disease progression in patients, including age, ethnic background, gender, HCV-specific cellular immune response, viral diversity, alcohol use, obesity, insulin resistance, viral co-infection, environmental factors and geography.Fibrosis and histological activity index (HAI) scores of patients were determined with both Knodell?s and İshak?s staging systems. The relationship between these scores and demographic findings, habits, concomitant diseases, and basic laboratory findings of patients was investigated.In this study, 60 women and 41 men, a total of 101 patients with chronic hepatitis C (CHC) were included. The mean age of patients was 50 ± 11.82 years. Significant positive correlations were found between fibrosis scores with age, body mass index (BMI), type 2 diabetes mellitus (T2DM), hypertension, HOMA-IR (Homeostasis Model Assessment-Insulin Resistance), coagulation parameters, hepatic function tests and HCV RNA levels. Significant negative correlations were found between fibrosis scores with platelet count and albumin levels (for each; p < 0.05). Significant positive correlations were found between HAI scores with age, BMI, T2DM, coagulation parameters, and hepatic function tests. Significant negative corelations were found between HAI scores with platelet count and albumin levels (for each; p < 0.05). There were no significant correlations between fibrosis and HAI scores with gender, mild-moderate smoking and alcohol use, hyperlipidemia, chronic lung diseases, renal function tests and lipid parameters.It is concluded that metabolic syndrome can be effective in terms of disease progression in patients with CHC, when the age, BMI, T2DM, hypertension and HOMA-IR considered together. Metabolic syndrome must be investigated in all patients with CHC.
Description
Keywords
Kronik hepatit C, Fibrozis, Demografik bulgular, Chronic hepatitis C, Fibrosis, Demographic findings
Citation
Yoğurt, İ. (2012). Kronik hepatit c tanılı hastalarda karaciğer fibrozisi ile demografik bulgular arasındaki ilişkinin belirlenmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.