HBsAg Pozitif Hastaların Trombosit/Lenfosit, Trombosit/Nötrofil, Nötrofil/Lenfosit ve PLT/MPV Düzeylerinin Araştırılması

Öz

Amaç: Hepatit B virüs (HPV) enfeksiyonu tüm dünyada olduğu gibi ülkemizde de oluşturduğu tablolar ve sonuçlar bakımından önemli mortalite ve morbidite sebeplerinden biridir. Bu çalışmada, hepatit B yüzey antijen (HBsAg) pozitif hastalarda Trombosit/Lenfosit (TLO), Trombosit/Nötrofil (TNO), Nötrofil/Lenfosit (NLO) ve PLT/MPV oranlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya Uşak Eğitim ve Araştırma Hastanesi polikliniklerine başvuran, HBsAg pozitifliği olan, tam kan sayımı parametreleri çalışılmış 200 hasta, kontrol grubu olarak ise aynı hastaneye başvuran ve tam kan sayımı parametreleri çalışılmış HBsAg’si negatif olan 200 hasta dahil edilmiştir. Bulgular: HBsAg-pozitif grupta lenfosit değerleri kontrol grubuna göre istatistiksel olarak anlamlı derecede düşük bulundu (p<0.05). HBsAg-pozitif grupta MPV değerleri kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek bulundu (p<0.05). Hem hasta grubunda hem de kontrol grubunda trombosit sayısı ile MPV arasında pozitif korelasyon vardı (sırasıyla r=0.34, p=0.01 ve r=0.32, p=0.01). Tartışma ve Sonuç: HBV ile enfekte bireylerde inflamasyon düzeyinin belirlenmesi hastaların takibi yönünden önemlidir Daha büyük sayıdaki hasta popülasyonları ile çok merkezli, prospektif olarak yapılacak çalışmalar hepatit B ile NLO, PLO, TNO ve PLT/MPV ilişkisi konusunda daha aydınlatıcı fikirler verebilir.

Anahtar Kelimeler

• Hepatit B virüs
• Nötrofil/Lenfosit
• Platalet/Lenfosit

Examination of Platelet/Lymphocyte, Platelet/Neutrophil, Neutrophil/Lymphocyte and PLT/MPV Levels of HBsAg Positive Patients

Öz

Abstrac Introductıon: Hepatitis B virus (HPV) infection is one of the important causes of mortality and morbidity in terms of the tables and results it creates in our country as well as all over the world. The aim of study, Platelet/Lymphocyte (PLR), Platelet/Neutrophil (PNR), Neutrophil/Lymphocyte (NLR) and PLT/MPV ratio values were retrospectively evaluated in patients with positive hepatitis B surface antigen (HBsAg). Material and Methods: 200 patients who applied to Uşak Training and Research Hospital outpatient clinics who had HBsAg positivity, whose complete blood count parameters were studied, and as control group, 200 patients who applied to the same hospital with negative HBsAg, whose complete blood count parameters were studied were included in this study. Results: Lymphocyte values were significantly lower in the HBsAg-positive group compared to the control group (p<0.05). MPV values were significantly higher in HBsAg-positive group compared to the control group (p<0.05). There was a positive correlation between platelet count and MPV in both patient group and control group (r=0.34, p=0.01 and r=0.32, p= 0.01, respectively). Dıscussıon and Conclusıon: Determining the level of inflammation in individuals infected with HBV is important for the follow-up of patients. Multi-centered, prospective studies with larger patient populations can provide more enlightening ideas about the relationship between hepatitis B and NLR, PLR, PNR and PLT/MPV.

Anahtar Kelimeler

• Hepatitis B virus
• Neutrophil/Lymphocyte
• Platelet/Lymphocyte

Kaynakça

1. 1. Nassal M. Hepatitis B viruses: reverse transcription a different way. Virus Res 2008;134:235-249.
2. 2. Zafrin N, Sarkar M.A.S., Rahman Md. M, Salma U, Mahbub T, Azhar M.A. Hepatitis B Virus Infection: Knowledge and Awareness Among the Patients Admitted in a Tertiary Care Hospital in Bangladesh. 2019;25:6-13.
3. 3. Perz JF, Armstrong GL, Farrington LA, et al. The contributions of hepatitis B virüs and hepatitis C virüs infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006;4:529-38.
4. 4. Baş B. Prevalence and interfamily transmission pathways of hepatitis B virüs. Akademik Gastroenteroloji Dergisi 2017;16(1):12-17.
5. 5. Liu H, Zhang H, Wan G, Sang Y, Chang Y, Wang X, Zeng H. Neutrophil-lymphocyte ratio: a novel predictor for short-term prognosis in acute-on-chronic hepatitis B liver failure. Journal of Viral Hepatitis 2014;21:499-507.
6. 6. Uluca U, Sen V, Gunes A, Tan I, Aktar F, Cubuk E, Sabaz MN. Evaluation of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume in Inactive Hepatitis B Carriers. Mustafa Kemal Üniversitesi Tıp Dergisi 2015; 6(22): 8-13.
7. 7. Oylumlu M, Yıldız A, Yüksel M, Korkmaz A, Aydın M, Bilik MZ, Akıl MA, Ülgen S. Usefulness of Platelet-Lymphocyte Ratio to Predict Stent Thrombosis in Patients with ST Elevation Myocardial Infarction Koşuyolu Heart Journal 2014;17(2):81-85.
8. 8. Chung J. H., Lim J., Jeong J. H., Kim K. R., Park C. W., Lee S. H: The significance of neu- trophil to lymphocyte ratio and platelet to lymphocyte ratio in vestibular neuritis. Laryngoscope 2015;125(7):257–261.

9. 9. Atay K. Relationship between neutrophil-to-lymphocyte ratio, mean platelet volume, and fibrosis level in patients with chronic hepatitis B. The Turkish Journal of Academic Gastroenterology 2019;18:7-11.
10. 10.Karabulut N, Namlı MN. Evaluation of Platelet Indices of HBsAg Positive Patients. ANKEM Derg 2015;29(2):73-78.
11. 11.Ozer S, Yilmaz R, Sonmezgoz E, Karaaslan E, Taskin S, Butun I, Demir O. Simple markers for subclinical inflammation in patients with Familial Mediterranean Fever. Medical Science Monitor: İnternational medical journal of experimental and clinical research 2015;21:298-303.
12. 12.European Association for the Study of the Liver. Clinical Practice Guidelines on the management of hepatitis B virüs infection. J Hepatol 2017; 67:370–398.
13. 13.World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. Geneva, 2015:1-134.
14. 14.Yamazhan T. HBV enfeksiyonunun epidemiyolojisi. Hepatit B‟den D‟ye Hep Güncel Klinik El Kitabı. Ed: Kandemir Ö, Danalıoğlu A. Viral Hepatitle Savaşım Derneği, 2015:17-21.
15. 15.Güçlü E, Geyik MF. Hepatit B Enfeksiyonu ve Korunma. Konuralp Tıp Dergisi 2012; 4(2):54-58.
16. 16.Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2007;45:507-539.
17. 17.Atay K. Relationship between neutrophil-to-lymphocyte ratio, mean platelet volume, and fibrosis level in patients with chronic hepatitis B. The Turkish Journal of Academic Gastroenterology 2019;18:7-11.
18. 18.Noris P, Melazzini F, Balduini CL. New roles for mean platelet volume measurement in the clinical practice? Platelets 2016;27(7):607-612.
19. 19.Henning BF, Zidek W, Linder B, Tepel M. Mean platelet volüme and coronary heart disease in hemodialysis patients. Kidney Blood Press Res 2002;25:103-108.
20. 20.Ekiz F, Yüksel O, Koçak E, et al. Mean platelet volume as a fibrosis marker in patients with chronic hepatitis B. J Clin Lab Anal 2011;25:162-5.
21. 21.Turhan O, Coban E, Inan D, Yalcin AN. Increased mean platelet volume in chronic hepatitis B patients with inactive disease. Med Sci Monit 2010;16:202-205.
22. 22.Atakan-Erkal F, Sepin-Özen N, Emek M, Tuğlu-Ataman Ş, Yalçınkaya M, Aksoy N, Özdemir M. Increased mean platelet volume, red blood cell distribution width and platelet / red blood cell distribution width in patients with Hepatitis B.Turk Hij Den Biyol Derg 2019; 76(1):53-58.
23. 23.Lindsay BN. The immune system. Essays Biochem. 2016; 60(3): 275–301.
24. 24.Zahorec R. Ratio of neutrophil to lymphocyte counts-Rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001;102: 5-14.
25. 25.Li C, Wen TF, Yan LN, et al. Postoperative neutrophil-tolymphocyte ratio plus platelet-tolymphocyte ratio predicts the outcomes of hepatocellular carcinoma. The Journal of Surgical Research 2015; 198:73–9.
26. 26.Uluca U, Sen V, Gunes A, Tan I, Aktar F, Cubuk E, Sabaz MN. Evaluation of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume in Inactive Hepatitis B Carriers. Mustafa Kemal Üniversitesi Tıp Dergisi 2015;(6)22:8-13.