Dekompanse Siroz Hastalarında Özofagus Varis Varlığı ile Periostin Düzeyleri Arasındaki İlişki

Yıl 2024, Cilt: 11 Sayı: 2, 88 - 96, 31.08.2024

Çağdaş Kunt , Korhan Kollu , Fatma Büşra Çakır Kunt , Barış Can Ünal , Gökhan Güngör , Muhammet Cemal Kızılarslanoğlu , İbrahim Güney

https://doi.org/10.47572/muskutd.1429164

Öz

Özofagus varisleri, dekompanse karaciğer sirozu hastalarında hastalığın şiddeti ile ilişkili olarak ortaya çıkan ve hayatı tehdit eden bir komplikasyondur. Bu çalışmada, dekompanse siroz hastalarında özofagus varis gelişimi ile serum periostin düzeyi arasında ilişki olup olmadığı incelenecektir. Dekompanse karaciğer sirozu tanısı olan ve üst GIS endoskopisi yapılan 18-70 yaş aralığındaki hastalar bu çalışmaya dâhil edildi. Hastaların serum periostin düzeyi ile özofagus varis gelişimi arasındaki ilişki incelendi. Özofagus varisi olan hastalar, varis evrelerine göre evre I, II ve III şeklinde üç gruba ayrılıp grupların periostin seviyeleri karşılaştırıldı. Hastaların 43’ü (%54.4) kadın, 36’sı (%45.6) erkekti ve yaş medyan değeri 62 (20-70) olarak hesaplandı. Hastaların 60’ında (%75.9) özofagus varisi mevcuttu (evre I; n=16, evre II; n=23, evre III; n=21). Özofagus varisi olan grubun serum periostin düzeyi, varisi olmayan gruba nazaran daha yüksekti ancak fark istatistiksel olarak anlamlı düzeyde değildi (p=0.222). Özofagus varisi olan hastalar varis evrelerine göre karşılaştırıldığında, gruplar arasında periostin seviyeleri açısından anlamlı fark yoktu (p=0.480). Korelasyon analizinde, periostin ile CHILD skoru (r=0.307, p=0.006), GPR (r=0.279, p=0.013), APRI (r=0.283, p=0.011), FIB-4 skoru (r=0.286, p=0.011) ve INR değeri (r=0.235, p=0.037) arasında pozitif korelasyon, P2/MS skoru (r=-0.275, p=0.014), trombosit (r=-0.282, p=0.012) ve albumin (r=0.356, p=0.001) arasında negatif korelasyon tespit edildi. Serum periostin düzeyi ile özofagus varisi varlığı ve varis evreleri arasında anlamlı ilişki bulunamadı. Periostin ile birçok prognostik belirteç arasında korelasyon bulunması, periostinin siroz hastalarında potansiyel bir prognostik belirteç olabileceğini düşündürdü.

Anahtar Kelimeler

Dekompanse Karaciğer Sirozu, Fibrozis, Özofagus Varisi, Periostin

The Relationship between Periostin Level and the Presence of Esophageal Varices in Patients with Decompensated Cirrhosis

Öz

Esophageal varices are life-threatening complications of decompensated liver cirrhosis. Herein, it was aimed to explore the relationship between esophageal varices and serum periostin levels in decompensated cirrhosis patients. Decompensated liver cirrhosis patients (18-70 years) undergoing upper gastrointestinal (GIS) endoscopy were included in the study. The relationship between serum periostin and esophageal varices was investigated. Those with esophageal varices were divided into three groups: stages I, II, and III, and the periostin levels of the groups were compared. Forty-three (54.4%) patients were female, and the median age was 62 years (20-70 years). Sixty (75.9%) patients had esophageal varices (stage I, n=16; stage II, n=23; stage III, n=21). Although serum periostin level was higher in those with esophageal varices than those without, the difference was not statistically significant (p=0.222). Given the grades of esophageal varices, no significant difference was seen between the groups concerning periostin levels (p=0.480). In analyses, statistically significant positive correlations were found between periostin levels and Child-Pugh score (r=0.307, p=0.006), gamma-glutamyl transpeptidase to platelet ratio (GPR) (r=0.279, p=0.013), aminotransferase (AST)/platelet ratio index (APRI) (r=0.283, p=0.011), fibrosis-4 (FIB-4) score (r=0.286 p=0.011), and international normalized ratio (INR) value (r=0.235, p=0.037), and negative correlations between periostin levels and P2/MS scores (r=-0.275, p=0.014), platelet (r=-0.282, p=0.012) and albumin (r=0.356, p=0.001). There was no significant relationship between serum periostin levels and the presence and grade of esophageal varices. The correlation between periostin and other prognostic markers suggested that periostin might be a potential prognostic marker in cirrhosis patients.

Anahtar Kelimeler

Decompensated Liver Cirrhosis, Fibrosis, Esophageal Varices, Periostin

Kaynakça

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