Kompanse siroz tanısında platelet sayısı ve ultrasonografik dalak alanının non-invaziv belirteç olarak değeri

Amaç: Bu çalışmanın amacı, kompanse sirozu kronik hepatitten ayırmada platelet sayısı ve ultrasonografik dalak alanının değerini araştırmaktır. Gereç ve Yöntem: Bu çalışmaya karaciğer sirozlu 92 hasta, kronik hepatitli 73 hasta ve 91 sağlıklı kontrol alındı. Kompanse sirozu kronik hepatitten ayırmada platelet sayısı ve dalak alanının cut off değerleri receiver operating curves analizi ile saptandı. Bulgular: Ortalama platelet seviyesi karaciğer sirozu hastalarında 109.6±43 K/μL, kronik hepatit hastalarında 237.3±45 K/μL, sağlıklı kontrollerde ise 296.1±52 K/μL olarak saptandı. Platelet seviyesi her iki hasta grubunda da sağlıklı kontrollere göre anlamlı oranda düşüktü (p

The value of platelet count and ultrasonographic spleen size as non-invasive predictors of compensated cirrhosis

Background and Aims: The purpose of this study was to investigate the value of platelet level and spleen size for discrimination of compensated cirrhosis from chronic hepatitis. Methods: Ninety-two patients with liver cirrhosis, 73 patients with chronic hepatitis (CH) and 91 healthy controls were enrolled in this study. The cut-off values of peripheral platelet count and spleen area were determined for chronic hepatitis and liver cirrhosis by receiver operating curve analysis. Results: The mean platelet levels were significantly lower in liver cirrhosis and chronic hepatitis patients (mean±SD: 109.6±43 K/&#956;L and 237.3±45 K/&#956;L, respectively) compared with the controls (296.1±52 K/&#956;L, p<0.001 for both). The mean spleen areas were significantly larger in liver cirrhosis and chronic hepatitis patients (78.5±29 cm2 and 43.9±14 cm2, respectively) compared with the controls (34.6±8 cm2, p<0.001 for both). A platelet count <179 K/&#956;L had the highest discriminative value for cirrhosis, with a sensitivity of 92.5% and a specificity of 92%. A spleen area >56.5 cm2 had the highest discriminative value for cirrhosis, with a sensitivity of 81.5% and a specificity of 80%. Spleen area >52 cm2 and platelet count <179 K/&#956;L had discriminative value for cirrhosis, with a sensitivity of 81.5% and a specificity of 94.5%. The positive predictive value, negative predictive value and accuracy were 94.9%, 80.2% and 87.2%, respectively. Conclusions: A platelet level even above the commonly accepted lower limit and spleen size can be used to predict the presence of compensated cirrhosis; in other words, to differentiate cirrhosis from chronic hepatitis without biopsy.

Kaynakça

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Kaynak Göster

Akademik Gastroenteroloji Dergisi
  • ISSN: 1303-6629
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2002
  • Yayıncı: Jülide Gülay Özler

8.2b5.7b

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