Akut Romatizmal Ateşe Bağlı Kardit Gelişen Hastalarda Penisilin Profilaksisinin Etkinliğinin Değerlendirilmesi

Öz

Amaç: Akut Romatizmal Ateşi (ARA) olan hastalarda primer ve sekonder penisilin profilaksisinin etkinliği değerlendirilmiştir.Gereç ve Yöntemler: Pediyatrik kardiyoloji polikliniğinde Kasım 1997–Ağustos 2012 tarihleri arasında ARA tanısıyla izlenen hastalar retrospektif olarak demografik ve klinik özellikleri açısından incelenmiştir.Bulgular: Çalışmaya ARA tanısı alan 71 hasta dahil edildi. Hastaların %53.5’i kız, %46.5’i erkekti. Hastaların ortalama yaşları 10.8±3.0 yıl’dı. En sık etkilenim kardiyak olup hastaların %90`nında görülmüştür. Karditli olguların %96`sında mitral kapak tutulumu gözlenmiştir. En sık tutulum şekli mitral yetersizliği (MY) ve aort yetersizliğinin (AY) birlikteliği olup, 33 (%51.6) hastada gözlenmiştir. ARA tanısı konulan tüm hastalar primer ve sekonder penisilin profilaksisi alıyordu. Tedavi sonrası ortalama 3.4±2.7 yıl izlenen karditli hastalardan; MY olan 62 hastanın 20’inde (%32.2) mitral kapak tutulum derecesinde gerileme, 7 (%11.3) hastada ise tam düzelme gözlendi. AY olan 35 hastanın 7’inde (%20) AY derecesinde gerileme, 10 (%28.6) hastada ise tam düzelme gözlendi.Sonuç: ARA, akut dönemde tedavi edilip primer ve sekonder penisillin profilaksisi yapıldığında mekanik kapak replasmanı gibi önemli morbiditelerin önlenebildiği bir hastalıktır.

Anahtar Kelimeler

• Romatizmal ateş, Benzatin penisilin, Antibiyotik profilaksisi

Evaluation of the Effi cacy of Penicillin Prophylaxis in Patients with Carditis due to Acute Rheumatic Fever

Öz

Objective: To show the effectiveness of primary and secondary penicillin prophylaxis for acute rheumatic fever patients.Material and Methods: Patients diagnosed with acute rheumatic fever and followed-up at the pediatric cardiology department between November 1997 and August 2012 were studied retrospectively regarding their demographic and clinical characteristics. Results: We included 71 patients (53.5% female and 46.5% male) diagnosed with Acute Rheumatic Fever (ARF) in this study. The mean age of the patients was 10.8±3.0 years. Carditis was the most frequent clinical fi nding and was seen in 90%. The mitral valve was affected in 96% of the carditis patients. The most frequent valvular involvement was combined mitral regurgitation (MR) and aortic regurgitation (AR), seen in 33 (51.6%) of the patients. Primary and secondary penicillin prophylaxis were provided to all patients. The patients with carditis were followed up for a mean duration of 3.4±2.7 years after the diagnosis. The degree of MR was decreased in 20 (32.2%) cases and the MR completely recovered in 7 (11.3%) cases among the 62 patients with MR. The degree of AR decreased in 7 (20%) cases and the AR recovered completely in 10 (28.6%%) cases among the 35 AR patients.Conclusion: The important morbidity caused by ARF can be prevented with the primary penicillin prophylaxis in the acute phase and secondary penicillin prophylaxis afterwards

Anahtar Kelimeler

• Rheumatic fever, Penicillin G benzathine, Antibiotic prophylaxis

Kaynakça

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