Agustos 2008
Inflamatuvar barsak hastaliklarinda anemi ve serum eritropoietin düzeyleri
Anemia and serum erythropoietin levels in patients with inflammatory bowel disease
- Ana Sayfa
- Sayılar
- Agustos 2008
- Inflamatuvar barsak hastaliklarinda anemi ve serum eritropoietin düzeyleri...
Özet
Giris ve Amaç: Anemi inflamatuvar barsak hastaligi olan hastalar için önemli bir problem olup, primer hastaligin prognozunu, tedaviye yaniti, hastanin yasam kalitesini önemli ölçüde etkiler. Çalismami zda Ülseratif kolit ve Crohn hastaligi olan olgularda anemiye eritropoietin yanitini ve bu yanit üzerine etkili olabilecek faktörleri arastirmayi hedefledik. Gereç ve Yöntem: 106 inflamatuvar barsak hastasi, bu dönemde Gastroenteroloji Servisi Yogun Bakim Ünitesinde izlenen 39 akut gastrointestinal sistem kanamali hasta ile 16 gönüllü saglikli kisi incelenmistir. Ülseratif kolit hastalari lokalizasyonlari na göre 3 grupta incelenmislerdir. Hastaligin siddeti Rachmilewitz Endoskopik Aktivite Indeksi ile belirlenmistir. Crohn hastalari lokalizasyonlarina göre 3 grupta incelenmislerdir. Hastaligin siddeti CDAI kriterlerine göre belirlenmistir. Tüm hasta grubunda demir eksikligi anemisi ve kronik hastalik anemisi olanlarda serum eritropoietin düzeyleri ELISA yöntemi ile ölçülmüstür. Bulgular: Saglikli kontrol grubu ile Ülseratif kolit, Crohn hastaligi ve GIS Kanamali gruplar arasinda eritropoietin ve hemoglobin degerleri açisindan istatistiksel olarak anlamli fark saptandi. (p<0.05). Crohn hastalarinda hemoglobin ve eritropoietin degerleri arasinda ters yönlü bir iliski oldugu tespit edildi (r= -0,352, p= 0,011). Ülseratif kolit grubunda ise korelasyon tespit edilmedi (r= 0,767). Ülseratif kolit ve Crohn hastalarinin anemik olanlarinin aktivasyon ve remisyon gruplari nda hemoglobin ve eritropoietin düzeyleri arasinda istatistiksel fark yoktu (p>0,05). Ülseratif kolit hastalarinda hemoglobin düzeyi düstügü halde eritropoietin düzeyi artmaz iken Crohn hastalarinda anemik olgularda hemoglobin düzeyi düser iken eritropoietin düzeyi artiyordu. Sonuç: Sonuç olarak inflamatuvar barsak hastaligi olan olgularda anemiye eritropoietin yanitini inceledigimiz arastirmamizda, Crohn hastaligi-kronik hastalik anemisi grubunda anemiye baskili eritropoietin yaniti oldugunu tespit ettik.
Abstract
Background and Aims: Anemia is an important problem in patients with inflammatory bowel disease, affecting the prognosis, response to treatment and quality of life of the patients. In this study, we aimed to investigate the response of erythropoietin to anemia in patients with ulcerative colitis and Crohn’s disease and to determine the factors that might be operative in this response. Materials and Methods: A total of 106 patients with inflammatory bowel disease along with 36 patients with acute gastrointestinal hemorrhage and 16 healthy volunteers were evaluated in this study. Patients with ulcerative colitis were divided into three groups according to the disease localization, and the severity of the disease was recorded according to the Rachmilewitz endoscopic activity index. Similarly, patients with Crohn’s disease were divided into three groups according to the disease localization, and the severity of the disease was recorded according to the Crohn’s Disease Activity Index (CDAI) criteria. Serum erythropoietin levels were analyzed by ELISA technique. Results: No statistically significant differences were determined between patient groups and controls with respect to erythropoietin and hemoglobin levels. There was a reverse relation between the erythropoietin and hemoglobin levels in patients with Crohn’s disease (r= -0.352, p=0.011), and no correlation was found in patients with ulcerative colitis. The hemoglobin and erythropoietin levels were not statistically different in the active and remission groups of the patients with anemia (p>0.05). The erythropoietin levels were not increased in ulcerative colitis patients with anemia but were increased in patients with Crohn’s disease. Conclusions: In our study evaluating the erythropoietin response to anemia in inflammatory bowel disease, patients with Crohn’s disease were shown to have a reduced erythropoietin response to chronic anemia.
