Nimet AKSEL, Aydan MERTOĞLU, Hülya DOĞAN, Şevket DERELİ, Ayşe ÖZSÖZ

508524

AKCİĞER TÜBERKÜLOZLU KADIN VE ERKEK OLGULARIN KARŞILAŞTIRILMASI

Bu çalışma tüberkülozlu olgularda bakteriyolojik, radyolojik, klinik özellikler, laboratuvar bulguları, ilaç direnç oranları, tedaviye yanıt ve yan etkiler yönünden kadın ve erkekler arasında fark olup olmadığını araştırmak amacıyla planlandı. Kliniğimizde 4 yıllık period içerisinde bu tanı ile yatan olguların retrospektif olarak dosya kayıtları incelenerek ilk 100 kadın (yaş ort. 48.9) ve 100 erkek olgu (yaş ort. 47.3.) çalışmaya alındı. Her iki grupta en sık rastlanan semptom öksürük olup, balgam çıkarma dışında, semptomlar açısından gruplar arasında anlamlı farklılık saptanmadı. Semptomların başlama süresi kadınlarda daha yüksek bulundu (p=0.552). Kadınlarda tüberkülozlu ile temas (p=0.014), erkeklerde alkol ve sigara alışkanlığı belirgin olarak daha yüksek oranda saptandı (p=0.000). Laboratuvar değerlerinde; anemiye kadınlarda, hipoalbuminemiye erkeklerde anlamlı ölçüde daha yüksek oranda rastlandı. Tüberküloz ilaçlarına karşı toplam direnç erkeklerde, daha yüksek oranda bulundu (p=0.268). En sık görülen yan etki hepatotoksisite idi (p=0.843). Bir aylık tedavi sonrası radyolojik yanıt bakımından gruplar arasında anlamlı fark saptanmadı (p=0.366). Kadın ve erkek tüberkülozlu olgular arasında hastalığın prognozunu ya da tedavisini değiştirecek herhangi bir özellik saptanmamıştır. Tüberküloz kontrol programları geliştirilmesinde cinsiyet farklılıkları konusuna karşı duyarlı olunmalıdır.
Anahtar Kelimeler:

Tüberküloz, kadın, erkek

COMPARISION OF THE MALE AND FEMALE CASES WITH PULMONARY TUBERCULOSIS

This study has been planned with the aim of researching the differences between male and female tuberculous cases according to bacteriological, radiological and clinical features, laboratory findings, rates of drug resistance, response to treatment and side effects of drugs. After retrospective analysis of the records of patients hospitalized in our clinic with the diagnosis of tuberculosis during a four year period, the first 100 male and 100 female cases have been included the study. While cough was the most frequent symptom in both groups, any significant difference wasn't observed among the symptoms except for sputum. The period of time for initiation of symptoms was longer in females (p=0.552). In females, the history of contact with tuberculous patient was significantly more (p=0.014), in males smoking and alcohol abuse were more (p=0.000). Among laboratory findings, anemia was more significant in females and hypoalbuminemia was more significant in males. The rate of total resistance to anti-tuberculosis agents was higher in males than in females (p=0.268). The most common side effect of treatment was hepato-toxicity and no difference was found between males and females according to the frequency of side effects (p=0.843). After a period of treatment for one month, any difference wasn't observed between the groups according to radiological response (p=0.366). Between male and female tuberculous cases, any statistically significant difference, that can alter the prognosis or treatment of tuberculosis, wasn't observed. Gender differences must be considered while developing tuberculosis control programmes.
Keywords:

Tuberculosis, male, female,

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  • 1. TC Sa¤l›k Bakanl›¤› Verem Savafl Daire Baflkanl›¤›. Türkiye’de Tüberkülozun Kontrolü ‹çin Baflvuru Kitab›. Ankara 2003.
  • 2. World Health Organization. TB advocacy, a practical guide. Geneva, Switzerland, World Health Organization, 1998.
  • 3. World Bank. Word Development report 1993: Investing In Health. Oxford University Pres, 1993.
  • 4. Grzybowski S, Enarson D. Tuberculosis. In: Simmons DH, ed. Current Pulmonolgy, Chicago, Year Book Medical Publishers, 1985; 73-96.
  • 5 Connolly M, Nunn P. Women and tuberculosis. World Health Stat Q 1996; 49: 115-20.
  • 6. Sony A. El Beyers DN, Enarson DA, Chan– Yeung M. Tuberculosis in women. In: Buist S, Mapp CE (eds). Respiratory Diseases In Women. ERS Monograph 25. 2003: 8; 152- 166. UK
  • 7. Burton RC, Ferguson P, Gray P, Hall M, Hayes M, Smart YC. Effects of age, gender, and sigarette smokingon human immunoregulatory T cell subsets: establishment of normal ranges and comparison with patients with colorectal cancer and multipl sclerosis. Diagn ‹mmunol 1983; 1: 216-23.
  • 8. Rook Gaw, Onjyebujoh P, Standford JL. Th1/Th2 switch and loss of CD4 cell in chronic infection; an immuno-endocrionological hypothesis not exclusive to HIV. Immunol Today 1993; 14: 568-9.
  • 9. Chan-Yeung M, Noertjojo K, Chan S L, Tam C M. Sex differences in tuberculosis in Hong Kong. Int J Tuberc Lung Dis 2002; 6: 11-18.
  • 10. Cassels A, Heineman E, LeClerq S. Tuberculosis case-finding in Eastern Nepal. Tubercle 1982; 63: 173-85.
  • 11. Boeree MJ, Harries AD, Godschalk P, et al. Gender differences in the relation to sputum submission and smear positive pulmonary tuberculosis in Malawi. Int J Tuberc Lung Dis 2000; 4: 882-4.
  • 12. Smith I. Women and tuberculosis; gender issues and tuberculosis control in Nepal. Nuffield Institute For Health, 1994.
  • 13. Cegielski JP, Goetz MB, Jacobsan JM, et al. Gender differences in early suspicion on tuberculosis in hospitalized, high risk patients during 4 epidemic years, 1987 to 1990. Infect Control Hosp Epidemiol 1997; 18: 237-43.
  • 14. Rieder HL, Snider DE, Cauthen GM. Extrapulmonary tuberculosis in United States. Am Rev Respir Dis 1990; 141: 347-51.
  • 15. Kalaç N, Baflay N, Mutluay N ‹. Ekstrapulmoner tutulum gösteren tüberküloz olgular›. Tüberküloz ve Toraks Dergisi 1999; 47: 213-5.
  • 16. Tavusbay N, Aksel N, Çakan A ve ark. Ekstrapulmoner Tüberkülozlu Olgular›m›z. Solunum Hastal›klar› Dergisi 2000; 11: 294-8.
  • 17. Matsushita Y, Ikeda N, Kurasawa T, et al. The characteristics of clinical features of pulmonary tuberculosis in female. Kekkaku 1996; 71: 391-8.
  • 18. Lomachenkov VD, Kosheleva GI. Psychological features of new male and female cases of pulmonary tuberculosis and their social adaptation. Probl Tuberc 1997; 3: 9-11.
  • 19. Johansson E, Long NH, Diwan V K, Winkist A. Attitudes to compliance with tuberculosis treatment among women and men in Vietman. Int J Tuberc Lung Dis 1999; 3: 862-8.
  • 20. Noertjojo J, Tam CM, Chan SL, Chan-Yeung M. Extrapulmonary tuberculosis in Hong Kong. Am J Respir Crit Care Med 2001; 163: 99.
  • 21. Van der Wef TSDG, Van der Mark TW. Patients compliance with tuberculosis treatment in Ghana: factors influencing adherence to therapy in a rural service programme. Tubercle 1990; 71: 247-52.
  • 22. Johansson E, Long N H, Diwan W K. Gender and tuberculosis control. Perspectives on health seeking behaviour among men and women in Vietnam. Health Policy 200; 52: 33-51.
  • 23. Nichter N. IlIness semantics and international health: the weak lungs. TB complex in the Philippines. Soc Sci Med 1994; 38: 649-63.
  • 24. Tahao¤lu K. Tüberküloz tedavisi s›ras›nda geliflen hepatotoksisitede klinik yaklafl›m. Ankem Dergisi 1998; 12: 378-83.
  • 25. Omerod LP, Skinner C, Wales C. Hepatotoxicity of antituberculosis drugs. Thorax 1996; 51: 11-3.
  • 26. Thampson NP, Caplinn ME, Hamilton MI, et al. Antituberculosis medication and the liver: Dangers and recomendations in management. Eur respir J 1995; 8: 1384-8.
  • 27. Steele MA, Burk RF, Des Prez RM. Toxic hepatitis with isoniazid and rifampin. Chest 1991; 99: 465-71.
  • 28. Moulding TS, Redeeker AG, Kanel GC. Twenty isoniasid-associated deaths in one state. Am Rev Respir Dis 1989; 140: 700-5.
  • 29. Do¤an H, Aksel N, Dereli fi, Özsöz A. Tüberkülozun yafll› ve gençlerdeki özelliklerinin karfl›laflt›r›lmas›. Akci¤er Arflivi 2001; 3: 100-6.
  • 30. Weber H, Schaaf HS, Beyers N, et al. The clinical and radiological features of tuberculosis in adolescents. Ann Trop Pediatr 2000; 20: 5-10.
  • 31. Özkara fi, fiipit T, Berktafl B ve ark. Tüberkülozda ilaç direncinin epidemiyolojik özellikleri. Solunum Hastal›klar› 1995; 6: 223-32.
İzmir Göğüs Hastanesi Dergisi-Cover
  • ISSN: 1300-4115
  • Yayın Aralığı: 3
  • Başlangıç: 1986
  • Yayıncı: Ali Cangül
Arşiv
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