Semih KALYON, Yasemin GÖKDEN

Kronik Hepatit-B hastalarında hematolojik parametrelerin karaciğer inflamasyonu ve fibrozu ile ilişkisi

Amaç: Bu çalışmada, kronik hepatit B (KHB) hastalarında karaciğerdeki enflamasyonun ve fibrozisin derecesini öngörebilecek hematolojik parametrelerin değerlendirilmesi amaçlanmaktadır. Yöntem: Hastanemiz iç hastalıkları ve gastroenteroloji polikliniğinde KHB tanısıyla takip edilen ve karaciğer biyopsisi yapılan 237 hasta çalışmaya alındı. Karaciğer biyopsisi yapılmadan hemen önceki Nötrofil/Lenfosit, Platelet/Lenfosit, MPV, MPV/Platelet ve MPV/Lenfosit değerleri hesaplandı. Bu parametrelerin viral serolojik bulgular, karaciğer fibrozisi (Kİ) ve histolojik aktivite indeksi (HAİ) ile arasındaki ilişki araştırıldı. Bulgular: 101’i (%43) kadın, 136’sı (%57) erkek 237 hastanın yaş ortalaması 42.56±11.7 yıl idi. MPV/Platelet, MPV/Lenfosit, HBeAg, HBV-DNA değerleri ile HAİ arasında pozitif yönde istatistiksel olarak anlamlı korelesyon bulundu (P<0.05). Ek olarak HBV-DNA düzeyi ile Kİ arasında da pozitif yönde istatistiksel olarak anlamlı korelasyon saptandı (p<0.05). HAİ <6 ile HAİ ≥6 olmak üzere iki grup karşılaştırıldığında; HAİ ≥6 olan grubun MPV, MPV/Platelet, MPV/Lenfosit, HBV-DNA düzeyleri daha yüksekti. (p<0.05). Hastalar HBeAg (+) ve (-) olarak iki gruba ayrılıdığında; HBeAg (+) grupta Kİ, HAİ ve HBV-DNA düzeyindeki yükseklik istatistiksel olarak da anlamlıydı. (p<0.05). Sonuç: MPV/Lenfosit, MPV/Platelet değerleri; KHB enfeksiyonunda karaciğer fibrozisini değerlendirmekten ziyade, karaciğerdeki histolojik enflamasyonu değerlendirebilen yardımcı bir parametre olabilir.

Anahtar Kelimeler:

Hepatit B, MPV, Lenfositler, MPV/Lenfosit, Plateletler, MPV/Platelet

Relationship of hematological parameters with liver inflammation and fibrosis in patients with chronic Hepatitis B

Objective: This study aims to evaluate the hematological parameters that can predict the inflammation and degree of fibrosis in the liver in chronic hepatitis B patients. Method: 237 patients who were followed up with the diagnosis of Chronic Hepatitis B in the internal medicine and gastroenterology outpatient clinics of our hospital and underwent liver biopsy were included in the study. Neutrophil/Lymphocyte, Platelet/Lymphocyte, MPV, MPV/Platelet, and MPV/Lymphocyte values were calculated just before liver biopsy. These parameters were compared with viral serological findings, liver fibrosis, and histological activity scores. Results: Among 237 patients, 101 (43%) female and 136 (57%) male, the mean age was 42.56±11.7. A statistically significant positive correlation was found between MPV/Platelet, MPV/Lymphocyte, HBeAg, HBV-DNA values, and HAI (P<0.05). In addition, a statistically significant positive correlation was found between the HBV-DNA level and the degree of Chronicity Index (p<0.05). When the patients were grouped regarding the HAI<6 or ≥6; MPV, MPV/Platelet, MPV/Lymphocyte, HBV-DNA values were statistically higher in the group with HAI≥6 (p<0.05). When the patients were divided into two groups as HBeAg (+) and (-); in the HBeAg (+) group, chronicity index, HAI, and HBV-DNA levels were found to be statistically significantly higher (p<0.05). Conclusion: MPV/Lymphocyte and MPV/Platelet ratios; In CHB infection, it may be an auxiliary parameter that can evaluate histological inflammation in the liver rather than assessing liver fibrosis.

Keywords:

Hepatitis B, MPV, Lymphocytes, MPV/Lymphocyte, Platelets, MPV/Platelet,

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