Comparison of Hematological Parameters Before and After Helicobacter Pylori Eradication

Yıl 2019, Cilt: 11 Sayı: 4, 176 - 190, 29.06.2020

Hasan Dilaveroğlu Şafak Şahin Türker Taşlıyurt

Öz

Objective:Helicobacter pylori (HP) is the most common chronic bacterial infection in humans. Due to this common infection, a variety of studies are being carried out in order to use simple, easily accessible and in expensive techniques for treatment success and follow-up. Hematologic parameters before and after HP eradication were compared in this study. Our aim was to evaluate the hematological parameters of HP after eradication the rapy and to demonstrate the success of treatment with an easily accessible, inexpensive and practical method. In particular, the question of the availability of new markers of inflammation, such as NLR, PLR and MPV.
Materials and Methods: Patients admitted to Gaziosmanpaşa University Medical Faculty Health Research and Practice Hospital Internal Diseases clinic between 2012-2017, endoscopic biopsy result HP positive patients were retrospectively screened. 154 patients with HP positive and post eradication urea breath test (UNT) negative were included. As control group, 100 patients with endoscopic biopsy result negative or non-chronic disease were included. Hematological parameters before and after treatment were evaluated.
Results: In our study, MPV was significantly increased before and after treatment (p<0.001). NLR, PLR were not statistically significant between the groups (p=0.895) (p=0.603). When the relationship between gastritis severity and inflammation was examined, hematological parameters were not statistically significant.
Conclusion: As a result, were commend that markers such as MPV, NLR, and PLR be more cautious so that they can be used to demonstrate HP eradication and systemic inflammation. Prospective studies are needed in larger patient groups in this regard.

Anahtar Kelimeler

Helicobacter pylori, mean platelet volume, neutrophil-lymphocyte ratio

Helikobakter Pilori Eradikasyonu Öncesi ile Sonrası Hematolojik Parametrelerin Karşılaştırılması

Öz

Amaç: Helikobakter pilori (HP), insanlardaki en yaygın kronik bakteriyel enfeksiyondur. Sık karşılaşılan bu enfeksiyon nedeniyle basit, kolay ulaşılabilen ve maliyeti ucuz tekniklerin tedavi başarısı ve takibinde kullanılması amacıyla çeşitli çalışmalar yapılmaktadır. Bu çalışmada HP eradikasyonu öncesi ve sonrası hematolojik parametreler karşılaştırıldı. Amacımız HP’nin eradikasyon tedavisi sonrası hematolojik parametrelerini inceleyerek, kolay ulaşılabilen, ucuz ve pratik bir yöntemle, tedavi başarısını gösterebilmekti. Özellikle nötrofillerin lenfositlere oranı (NLR), trombositlerin lenfositlere oranı (PLR) ve ortalama trombosit hacmi (MPV) gibi yeni gündeme gelen inflamasyon belirteçlerinin kullanılabilirliğini sorgulamaktı.
Gereç ve Yöntem: Gaziosmanpaşa Üniversitesi Tıp Fakültesi Sağlık Araştırma ve Uygulama Hastanesi İç Hastalıkları kliniğine 2012-2017 yılları arasında başvuran, endoskopik biyopsi sonucu HP pozitif gelen hastalar retrospektif olarak tarandı. HP pozitif olan ve eradikasyon sonrası üre nefes testi (UNT) negatif olan 154 hasta çalışmaya alındı. Kontrol grubu olarak, aktif veya kronik hastalığı olmayan endoskopik biyopsi sonucu negatif 100 hasta alındı. Tedavi öncesi ve sonrası hematolojik parametreler değerlendirildi.
Bulgular: Çalışmamızda tedavi öncesi ve sonrası hematolojik parametrelerden MPV anlamlı olarak artmış bulundu (p<0.001). NLR, PLR gruplar arasında istatistiksel olarak anlamlı saptanmadı (p=0.895)(p=0.603). Hastaların gastrit şiddeti ile inflamasyon arasındaki ilişki incelendiğinde hematolojik parametreler istatistiksel olarak anlamlı saptanmadı.
Sonuç: Sonuç olarak MPV, NLR ve PLR gibi belirteçlerin HP eradikasyonunun ve sistemik inflamasyonun gösterilmesinde kullanılabilmesi için daha temkinli olunmasını öneriyoruz. Bu konuda daha büyük hasta gruplarında prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Helikobakter pilori, ortalama trombosit hacmi, nötrofil-lenfosit oranı

Kaynakça

• 1. Yucel T, Aygin D, Sen S, Yucel O. The prevalence of Helicobacter pyroli and related factors among university students in Turkey. Japanese Journal of Infectious Diseases. 2008;61(3):179.
• 2. Maltfertheiner P, Megraud F, O’Morain C. Current concepts in the management of Helicobacter pylori infection business briefing. Eur Gastroenterol Rev. 2005:59-60.
• 3. Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, et al. Textbook of Diagnostic Microbiology. Mycology, sixth ed Lincott Willams & Wilkins. 2006:1151-243.
• 4. Ataseven H, Demir A, Keçeci M. Peptik ülsere bağlı üst gastrointestinal kanamalı olgularda Helicobacter pylori eradikasyonunun fekal antijen testi ile tespiti. FÜ Tıp Fak Derg. 2004;18(2):199-204.
• 5. Bulut M, Armağan E, Kıyıcı M, Balcı V, Atar N, Gürel S. Acil servise epigastrik ağrı yakınmasıyla başvuran hastalarda Helicobacter pylori sıklığı ve tanıda kalitatif serum IgG testinin yeri. Uludağ Üni Tıp Fak Derg. 2004;30(1):7-10.
• 6. Malfertheiner P, Megraud F, O'morain CA, Atherton J, Axon AT, Bazzoli F, et al. Management of Helicobacter pylori infection—the Maastricht IV/Florence consensus report. Gut. 2012;61(5):646-64.
• 7. Shiotani A, Dore MP, Graham DY. Urea breath test and rapid urease test. Helicobacter pylori: Springer; 2016. p. 143-55.
• 8. Yuri Gasparyan A, Ayvazyan L, P Mikhailidis D, D Kitas G. Mean platelet volume: a link between thrombosis and inflammation? Current Pharmaceutical Design. 2011;17(1):47-58.
• 9. Gasbarrini A, Franceschi F, Tartaglione R, Landolfi R, Pola P, Gasbarrini G. Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori. The Lancet. 1998;352(9131):878.
• 10. Cave DR. Transmission and epidemiology of Helicobacter pylori. The American Journal of Medicine. 1996;100:12-17.
• 11. Pounder R, Ng D. The prevalence of Helicobacter pylori infection in different countries. Alimentary pharmacology & therapeutics. 1995;9:33-9.
• 12. Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clinica Chimica Acta. 2008;395(1):27-31.
• 13. Farah R, Khamisy-Farah R. Association of neutrophil to lymphocyte ratio with presence and severity of gastritis due to Helicobacter pylori infection. Journal of Clinical Laboratory Analysis. 2014;28(3):219-23.
• 14. Fehmi A, Yaraş S, Sarıtaş B, Altıntaş E, Sezgin O, Orekici G. Kan nötrofil/lenfosit oranının eroziv özofajitle ilişkisi. Endoskopi Dergisi. 2011;19(3).
• 15. Meng X, Wei G, Chang Q, Peng R, Shi G, Zheng P, et al. The platelet-to-lymphocyte ratio, superior to the neutrophil-to-lymphocyte ratio, correlates with hepatitis C virus infection. International Journal of Infectious Diseases. 2016;45:72-7.
• 16. Mertoglu C, Gunay M. Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017; 11(1):127-31.
• 17. Farah R, Hamza H, Khamisy-Farah R. A link between platelet to lymphocyte ratio and Helicobacter pylori infection. Journal of Clinical Laboratory Analysis. 2018;32(1):e22222
• 18. Bozdemir ŞE, Altıntop YA, Uytun S, Aslaner H, Torun YA. Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis. The Korean Journal of Internal Medicine. 2016;32:1075-81.
• 19. Bath P, Butterworth R, editors. Platelet size: measurement, physiology and vascular disease. Blood Coagulation & Fibrinolysis. 1996; 7(2): 157-61.
• 20. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG, Koutroubakis IE, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. The American Journal of Gastroenterology. 2001;96(3):776-81.
• 21. Gao S-Q, Huang L-D, Dai R-J, Chen D-D, Hu W-J, Shan Y-F. Neutrophil-lymphocyte ratio: a controversial marker in predicting Crohn’s disease severity. International Journal of Clinical and Experimental Pathology. 2015;8(11):14779.
• 22. Topal F, Karaman K, Akbulut S, Dincer N, Dolek Y, Cosgun Y, et al. The relationship between mean platelet volume levels and the inflammation in Helicobacter pylori gastritis. Journal of the National Medical Association. 2010;102(8):726-30.
• 23. Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine. 2008;75(3):291-4.
• 24. Fujimura K, Kuwana M, Kurata Y, Imamura M, Harada H, Sakamaki H, et al. Is eradication therapy useful as the first line of treatment in Helicobacter pylori-positive idiopathic thrombocytopenic purpura? Analysis of 207 eradicated chronic ITP cases in Japan. International Journal of Hematology. 2005;81(2):162-8.
• 25. Michel M, Cooper N, Jean C, Frissora C, Bussel JB. Does Helicobater pylori initiate or perpetuate immune thrombocytopenic purpura? Blood. 2004;103(3):890-6.
• 26. Hwang JJ, Lee DH, Yoon H, Shin CM, Park YS, Kim N. The effects of Helicobacter pylori eradication therapy for chronic idiopathic thrombocytopenic purpura. Gut and Liver. 2016;10(3):356.