BİROL ÖZER, Ender SERİN, Gülşah ŞEYDAOĞLU, Arif COŞAR, Fazilet KAYASELÇUK, Uğur YILMAZ

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 < 0.001 her ikisi için). Ortalama dalak alanı ise karaciğer sirozu ve kronik hepatit hastalarında sağlıklı kontrollere göre anlamlı olarak daha yüksekti (sırasıyla; 78.5±29 cm2, 43.9±14 cm2 ve 34.6±8 cm2) (p < 0.001 her ikisi için). Platelet seviyesinin 179 K/μL’den daha düşük düzeyleri sirozu ayırmada %92.5 sensitivite ve %92 spesifisite ile en yüksek değere sahipti. Dalak alanı da 56.5 cm2’nin üzerinde ise sirozu ayırmadaki sensitivitesi %81.5 ve spesifitesi de %80’e ulaşmaktaydı. Dalak alanı > 52 cm2 ve platelet sayısı < 179 K/μL olduğu kombinasyonun sirozu ayırmadaki sensitivitesi %81.5, spesifisitesi %94.5’ti. Pozitif prediktif değeri, negatif prediktif değeri ve doğruluğu sırasıyla %94.9, %80.2 ve %87.2 idi. Sonuç: Platelet düzeyi kabul edilen alt limitlerin üstünde olsa bile dalak alanı ile birlikte kompanse siroz varlığını belirlemede kullanılabilir. Elde edilen sonuçlar bu iki parametrenin biyopsi yapmaksızın sirozu kronik hepatitten ayırmada kullanılabilecek belirteçler olduğunu göstermektedir.

Anahtar Kelimeler:

Noninvasiv belirteç, siroz, platelet sayısı, dalak alanı

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/μL and 237.3±45 K/μL, respectively) compared with the controls (296.1±52 K/μL, p

Keywords:

Noninvasive predictor, cirrhosis, platelet count, spleen area,

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