Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi

Öz

GİRİŞ ve AMAÇ: Çalışmanın amacı, Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori (H.Pilori) pozitiflik oranının belirlenmesi; H.Pilori enfeksiyonunun, demir eksikliği anemisi (DEA) ve ilişkili hematolojik parametreler ile korelasyonunun değerlendirilmesidir.
YÖNTEM ve GEREÇLER: Çalışmaya gastrointestinal sistem semptomları nedeni ile C-14 üre nefes testi uygulanan çocuklar dahil edildi. Hemoglobin, hematokrit, ortalama eritrosit hacmi (n=852); serum demir düzeyi (n=175), demir bağlama kapasitesi (n=175), ferritin (n=197), transferrin satürasyonu (n=254) ve C-14 üre nefes testi sonuçları (n=1006) retrospektif olarak değerlendirildi. H.Pilori pozitiflik oranı belirlendi; H.Pilori pozitif ve negatif çocuklarda hematolojik parametreler karşılaştırıldı. 
BULGULAR: Çalışmaya dahil edilen çocuk hastaların %46,8’ inde H.Pilori pozitif idi. H.Pilori pozitif hastalarda hemoglobin ve hematokrit düzeylerinin negatif hastalara kıyasla anlamlı oranda düşük olduğu tespit edildi (hemoglobin için T: 4,014 P: 0,000; hematokrit için T: 3,486 P: 0,001). Ortalama eritrosit hacmi H.Pilori pozitif hastalarda düşük olmakla birlikte, istatistiksel olarak anlamlı değildi. Serum demir düzeyi (T: 2,297 P: 0,023), ferritin düzeyi (T: 2,19 P: 0,03) ve transferrin saturasyonu (T: 2,541 P: 0,012) H.Pilori pozitif hastalarda anlamlı düzeyde düşük saptandı. Demir bağlama kapasitesi açısından anlamlı fark izlenmedi. Anemik çocuklarda (x²: 23,533 P: 0,000), transferrin düzeyi düşük olan çocuklarda (x²: 4,948 P: 0,026), ferritin düzeyi düşük olan çocuklarda (x²: 6,96 P: 0,008) ve ferritin düzeyi düşük olan anemik çocuklarda (x²: 13,74 P: 0,00) H.Pilori pozitiflik oranının yüksek olduğu tespit edildi. Kızlarda ve erkeklerde H.Pilori pozitif çocuklarda anemi oranı anlamlı düzeyde yüksek bulundu (kızlarda x²: 9,033 P: 0,003; erkeklerde x²: 15,016 P: 0,000). 
TARTIŞMA ve SONUÇ: Orta Karadeniz bölgesinde gastrointestinal sistem semptomu olan çocuklardaki H.Pilori pozitiflik oranının, ülkemizin diğer bölgelerindeki oranlar ile karşılaştırıldığında ortanca değer düzeylerinde olduğu düşünülmektedir. Çalışmaya dahil olan geniş pediatrik populasyondan elde edilen sonuçlar, H.Pilori enfeksiyonu ile DEA arasındaki ilişkiyi desteklemektedir

Anahtar Kelimeler

• Helikobakter Pilori,anemi,C-14 üre nefes testi

Pediatric Helicobacter Pylori infection prevalence and iron deficiency anemia coincidence among children in North Central Turkey

Öz

INTRODUCTION: To estimate Helicobacter Pylori (H.Pylori) prevalence, coincidence of iron deficiency anemia (IDA) and related hematological parameters in children of North Central Turkey. 
METHODS: Hemoglobin, hematocrit, mean corpuscular volume (n=852); serum iron level (n=175), iron binding capacity (n=175), ferritin (n=197), transferrin saturation (n=254) and 14C urea breath test results (n=1006) were reviewed in children with nonspecific gastrointestinal symptoms. H.Pylori prevalence was determined; hematological parameters were compared in H.Pylori positive and negative patients. 
RESULTS: Overall H.Pylori prevalence was 46,8%. Hemoglobin and hematocrit values were significantly lower in H. Pylori positive patients (T: 4,014 P: 0,000 for hemoglobin; T: 3,486 P: 0,001 for hematocrit). Although MCV values were lower in H. Pylori positive patients, the difference was not statistically significant.Serum iron levels (T: 2,297 P: 0,023), ferritin levels (T: 2,19 P: 0,03) and transferrin saturations (T: 2,541 P: 0,012) were significantly lower in H.Pylori positive patients. Iron binding capacity was higher in H.Pylori positive patients but this was also not significant. H.Pylori positivity is significantly higher in anemic patients (x²: 23,533 P: 0,000), in patients with low transferrin (x²: 4,948 P: 0,026), low ferritin (x²: 6,96 P: 0,008) and in patients with low ferritin and anemia together (x²: 13,74 P: 0,00). In females and males, anemia was significantly higher in H.Pylori positive patients (x²: 9,033 P: 0,003 and x²: 15,016 P: 0,000 in females and males respectively).
DISCUSSION AND CONCLUSION: H.Pylori positivity rate in the pediatric population of North Central Turkey seems to be a median value within the range of yet reported Turkish prevalence. There is an association between H.Pylori and IDA according to the results of a large pediatric population

Anahtar Kelimeler

• Helicobacter Pylori,anemia,14C urea breath test.

Kaynakça

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