Çocuklarda Helicobacter pylori Enfeksiyonunun Şiddetini Tespit Etmede Başlangıca göre Delta Değerlerinin Önemi

Öz

Giriş: Yetişkinlerde ağır formları görülmekle birlikte, Helicobacter pylori (H. pylori) enfeksiyonu genellikle çocukluk çağında kazanılır. Bu nedenle, çocukluk çağında H. pylori enfeksiyonunun erken tanısı çok önemlidir. Bu çalışmada, H. pylori enfeksiyonu tanısında 13C üre nefes testinin (ÜNT) duyarlılığını ve özgüllüğünü bulmayı, delta değeri (DOB) ile hastalığın şiddetini değerlendirmeyi amaçladık. Gereç ve Yöntem: Epigastrik ağrı ve/veya bulantı şikayeti ile başvuran 200 çocuğa UBT uygulandı. Hastalara özofagogastroduodenoskopi (ÖGD) yapıldı. ÜNT sonuçları histopatolojik bulgularla karşılaştırıldı. ROC eğrisi analizi ile H. pylori enfeksiyonunun şiddeti için bir belirleyici DOB değeri bulundu. Bulgular: Yaş ortalaması 13,50±2,98 yıl olan 193 hasta araştırmaya alındı. Bu hastaların 71’i (%36,8) ÜNT pozitif, 122’si (%63,2) negatif olarak tespit edildi. ÜNT pozitif olan 71 hastanın 60’ına, ÜNT negatif olan 122 hastanın 30’una ÖGD yapıldı. ÜNT’nin duyarlılığı %85,1, özgüllüğü %100 tespit edildi. Orta/belirgin H. pylori yoğunluğu için DOB kesim değeri %6 olarak bulundu. Sonuç: DOB değerleri ile H. pylori yoğunluğu ve enflamatuar aktivite arasındaki pozitif korelasyon, hastalığın şiddetini tespit etmek için bir avantaj olabilir.

Importance of Delta Over Baseline Values in Predicting the Severity of Helicobacter pylori Infection in Children

Abstract

Introduction:Although severe forms of the disease are seen in adults, the Helicobacter pylori (H. pylori) infection is usually acquired during childhood. Therefore, prompt diagnosis of H. pylori infection in childhood is of prime importance. In the present study, we aimed to identify the sensitivity and specificity of 13C urea breath test (UBT) in the diagnosis of H. pylori infection and to assess the severity of the disease with delta over baseline (DOB) values. Materials and Methods: UBT was administered to 200 children who presented with epigastric pain and/or nausea. Esophagogastroduodenoscopy (EGD) was performed in patients. UBT results were compared with histopathological findings. In the Area Under the ROC Curve analysis, a cutoff DOB value was found for the severity of H. pylori infection. Results: 193 children with a mean age of 13.50±2.98 years were included in the analysis. Of these, 71 (36.8%) patients had a positive UBT and 122 (63.2%) had a negative UBT. EGD was performed in 60 out of 71 patients with positive UBT and in 30 out of 122 patients with negative UBT. The sensitivity and specificity of UBT were 85.1% and 100%. DOB was found to be a significant predictor of moderate/marked H. pylori density at a cutoff value of 6%. Conclusions: The positive correlation detected between the level of DOB values and the density of H. pylori and inflammatory activity can be an advantage for detecting the severity of disease

Keywords

• H. pylori,
• urea breath test,
• child,

Kaynakça

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