Agustos 2013
Hepatit B hastalarinda nötrofil/lenfosit orani ile fibrosis arasindaki iliski
The relationship between fibrosis level and blood neutrophil to lymphocyte ratio in chronic HBV patients
- Ana Sayfa
- Sayılar
- Agustos 2013
- Hepatit B hastalarinda nötrofil/lenfosit orani ile fibrosis arasindaki iliski...
Özet
Giris ve Amaç:Son yillarda ilgi odagi haline gelen, degisik inflamatuvar ve neoplastik hastaliklar ile iliskilendirilen basit, ucuz ve efektif bir marker olan nötrofil-lenfosit orani öne çikmakta olup kronik hepatit B hastalarinda çalisilmamistir. Biz çalismamizda hepatit B tanisi ile hastalik düzeyini belirleme, tedavi karari alma gibi nedenlerle HBV DNA bakilan ve karaciger biyopsisi uygulanan hastalarin fibrozis düzeyi ile nötrofil-lenfosit orani arasindaki iliskiyi arastirdik.Materyal ve Metod: 2005-2010 yillari arasinda biyopsi alinmis 486 hepatit B hastasinin dosyasi retrospektif tarandi ve bu hastalardan çalisma kriterlerine uyan 268 naiv hasta bulundu Naiv hastalar çalismaya alinirken, daha önceden antiviral tedavi almis olan hastalar ve anti-Delta pozitif olanlar çalisma disi birakildilar.Bulgular:Biyopsi alinmis olan çalisma popülasyonu 163 (%60,8) erkek (yas: 38±13), 105 (%39,2) kadin (yas: 37±14) olmak üzere 268 (yas: 38±13) kisiden olusmaktaydi. Hastalarin fibrozis skoruna göre dagilimlarina bakildiginda 0/6=122 hasta (%45,5), 1/6=50 hasta (%18,7), 2/6=37 hasta (%13,8), 3/6=25 hasta (%9,3), 4/6=5 hasta (%1,9), 5/6=6 hasta (%2,2), 6/6=23 hasta (%8,6) seklinde dagilmaktaydi. Fibrozis skoru ile nötrofil-lenfosit orani (r: +0,510 p: 0,000), histolojik aktivite indeksi (r: +0,478 p: 0,000) arasinda anlamli korelasyon saptanirken, HBV DNA düzeyi arasinda anlamli bir korelasyon izlenmedi (r: +0,035 p: 0,556). Fibrozis skoru 0-1 olan hastalarin nötrofil-lenfosit orani degeri 1,6±0,5 iken fibrozis skoru 2-6 olanlarda 2,4±0,8 saptandi (p=0,000). Tartisma:Kronik hepatit B hastasini poliklinikte ilk kez gördügümüzde hastaligin evresi ve histopatolojik olarak karacigerin durumu hakkinda klinisyen olarak bir öngörüde bulunmak için nötrofil-lenfosit oraninin yararli olacagini düsünmekteyiz.
Abstract
Background and Aims: In recent years, the neutrophil to lymphocyte ratio has been popular as a simple, inexpensive and effective marker associated with various inflammatory and neoplastic diseases. This marker has not yet been investigated in chronic hepatitis B patients. In our study with hepatitis B patients, we aimed to investigate the relationship between fibrosis levels and the neutrophil to lymphocyte ratio for determining the disease severity and making treatment decisions using HBV-DNA and liver biopsy results. Materials and Methods:486 hepatitis B patients subjected to liver biopsy between 2005 and 2010 were screened retrospectively from patient charts. Only 268 naive patients fit the criteria for this study. Naive patients were included while patients treated with antiviral drugs and with a positive anti-Delta result were excluded from the study. Results:The study consisted of 268 (age: 38±13 years) patients with liver biopsies [163 (60.8%) males (age: 38±13), 105 (39.2%) females (age: 37±14)]. Fibrosis score distribution of the patients was as follows: 0/6: 122 patients (45.5%), 1/6: 50 patients (18.7%), 2/6: 37 patients (13.8%), 3/6: 25 patients (9.3%), 4/6: 5 patients (1.9%), 5/6: 6 patients (2.2%), and 6/6: 23 patients (8.6%). There was a significant correlation between fibrosis score and histological activity index (r: +0.478 p: 0.000), while HBV-DNA levels showed no significant correlation (r: +0.035, p: 0.556). Conclusions: The neutrophil to lymphocyte ratio is predicted to be useful in deciding the disease severity and histopathological grade of liver disease in chronic hepatitis B patients who are first seen in the outpatient clinic.
