Helicobacter Pylori Eradikasyon Tedavisi Sonrasi HastaTakibinde Nöltrofil Lenfosit Oranının Duyarlılık ve Özgüllüğü

Yıl 2022, , 202 - 207, 30.06.2022

Gökhan Yılmaz , Ece Yiğit

https://doi.org/10.34087/cbusbed.1015436

Öz

Giriş ve Amaç: Endoskopik olarak H. Pilory pozitifliği tespit edilen ve eradikasyon tedavisi uygulanan hastaların takibinde tedavinin başarısını gözlemlemek için NRL oranının sensitivite ve spesifitesini ortaya koymayı amaçladık.
Gereç ve Yöntem: İstanbul Medipol Üniversitesi Pendik Hastanesi, Endoskopi Ünitesi’nde, üst gastrointestinal sistem endoskopisi yapılan 386 hasta değerlendirildi. HP pozitif ve negatif olan hastaların nötrofil, lenfosit sayıları, nötrofil lenfosit oranları (NLO) karşılaştırıldı. HP pozitif olan 205 hastaya 2 haftalık üçlü tedavi ile H. pylori eradikasyonu uygulandı. Tedavi bitiminden 4 hafta sonra gaitada H. Pilori antijen testi yapıldı ve negatif sonuç eradikasyon olarak tanımlandı. Eş zamanlı olarak tüm hastalara tam kan sayımı yapılarak. NLO hesaplandı ve değerler eradike edilen ve edilemeyen gruplar arasında karşılaştırıldı.
Bulgular: H. Pilory eradikasyonu 100 (%48,7) hastada sağlanabilmişken 105 (%51,3) hastanın gaitada antijen testi pozitif olarak geldi. Bu iki grup arasında nötrofil sayıları (P<0,0001), lenfosit sayıları(P<0,0001), ile nötrofil lenfosit oranı (P<0,0001) arasında istatistiksel olarak anlamlı fark mevcuttu. Nötrofil /Lenfosit oranının cutoff değeri 2,058 alındığında Helikobakter pilori eradikasyonunu tespit etmedeki duyarlılık ve özgüllüğü sırasıyla %90,5 ve %85 olarak tespit edildi
Sonuç: Çalışmamızda, tam kan sayımında bulunan parametrelerden elde edilen nötrofil/lenfosit oranı HP (+) olgularda daha yüksek bulunmuştur. Bu belirtecin tedavi süresince ve tedaviden sonra hastaları takip etmek için yararlı olabileceğini ancak başarılı HP eradikasyonu tedavisinden sonra, takip belirteci olarak nötrofil/ lenfosit oranındaki değişiklikleri değerlendirmek için daha geniş örneklem grubu ile yapılacak daha çok sayıda çalışmaya ihtiyaç olduğunu düşünmekteyiz.

Anahtar Kelimeler

Helikobakter Pilori, Eradikasyon, Nötrofil Lenfosit oranı, Gastroskopi, Tam kan sayımı

Specificity, Sensitivity and Usefulness Of Neutrophil Lymphocyte Ratio In The Follow-Up Of Patients After Helicobacter Pylori Eradication Treatment

Öz

Objective: The aim of this study is to determine the sensitivity and specificity of the NLR ratio in order to assess treatment effectiveness in the follow-up of patients who are endoscopic H. pylori-positive and administered eradication therapy.
Materials and Methods: The Endoscopy Unit at Istanbul Medipol University Pendik Hospital evaluated 386 individuals who underwent upper gastrointestinal endoscopy. Neutrophil and lymphocyte counts, as well as neutrophil-to-lymphocyte ratios (NLR), were compared in HP positive and negative patients. H. pylori eradication was performed on 205 HP-positive patients using a 2-week triple therapy. All patients had a complete blood count done at the same time, and NLR was computed and compared between the eradicated and non-eradicated groups.
Results: H. pylori eradication was accomplished in 100 (48.7%) of the patients, whereas the stool antigen test was positive in 105 (51.3%) of the patients. There was a statistically significant difference in neutrophil counts (P<0.0001), lymphocyte counts (P<0.0001), and neutrophil-to-lymphocyte ratio (P<0.0001). The sensitivity and specificity in identifying Helicobacter pylori eradication were determined to be 90.5% and 85%, respectively when the cutoff value for the Neutrophil-to-Lymphocyte ratio was set at 2.058.
Conclusion: The neutrophil-to-lymphocyte ratio was shown to be greater in HP (+) cases based on the parameters discovered in the complete blood count in our study. We believe that this measure might be used to monitor patients during and after therapy, but additional research with larger sample sizes is needed to assess changes in neutrophil-to-lymphocyte ratio as a follow-up indicator following successful HP eradication therapy.

Anahtar Kelimeler

Helicobacter Pylori, Eradication, Neutrophil-to-Lymphocyte ratio, Gastroscopy, Complete blood count.

Kaynakça

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