Deniz KÖKSAL, Şeref ÖZKARA, Mine BERKOĞLU, S.Sevkan CANER, Dilek TARHAN, Sabahat AKSARAY

Akciğer tüberkülozlu hastalarda serum interlökin-2 ve C-reaktif protein düzeylerinin klinik ve radyolojik bulgularla ilişkisi

Tüberkülozda meydana gelen doku hasarından basil değil, immünolojik olaylar sorumludur. İmmünolojik olayların açığa kavuşturulmasıyla, tüberküloz hastalığının tedavisi ve korunmaya yönelik yeni yaklaşımlar geliştirilebilir. Bu çalışmanın amacı; akciğer tüberkülozlu hastalarda serum interlökin (IL)-2 ve C-reaktif protein (CRP) düzeylerini ortaya koymak; bunların klinik ve radyolojik bulgularla ilişkisini değerlendirmektir. Çalışmaya; yeni olgu akciğer tüberkülozu tanısı almış 60 hasta (yaş ortalaması: 37 ± 12 yıl, tümü erkek) ve 23 sağlıklı kontrol (yaş ortalaması: 40 ± 13 yıl, tümü erkek) alındı. Hastaların başvuru semptomları, klinik özellikleri, demografik verileri, laboratuvar tetkikleri ve radyolojik bulguları oluşturulan çalışma formuna kaydedildi. IL-2 ve CRP düzeylerinin belirlenmesi için alınan serum örnekleri -80°C’de saklandı. Serum IL-2 düzeyleri, tüberkülozlu hasta ve sağlıklı kontrol grubunda benzer bulurken; serum CRP düzeyleri tüberkülozlu hastalarda anlamlı olarak daha yüksek bulundu (p< 0.001). Serum IL-2 düzeyi ile kavite çapı arasında anlamlı pozitif ilişki mevcuttu (p= 0.012). Ateş (p= 0.001) ve kilo kaybı (p= 0.024) şikayetleriyle başvuran hastalarda CRP düzeyleri anlamlı olarak daha yüksekti. Dört ve üzerinde zon tutulumu olan (p= 0.029) ve çok sayıda kaviteli hastalığı olan (p= 0.001) hastalarda serum CRP düzeyleri anlamlı olarak daha yüksekti. Serum CRP düzeyi ile kavite çapı arasında anlamlı pozitif ilişki mevcuttu (p= 0.004). Sonuç olarak; serum IL-2 düzeyleri, kavite çapı dışında hiçbir klinik, laboratuvar ve radyolojik parametreyle ilişkili bulunmamıştır. Serum CRP düzeyleri ise hastalık ciddiyetinin iyi bir göstergesidir.

The relation of serum interleukin-2 and C-reactive protein levels with clinical and radiological findings in patients with pulmonary tuberculosis

Immunological events, not the bacilli, are responsible from the tissue damage of tuberculosis. Clarifing the immunological events may lead to the development of new approaches to treatment and defence against tuberculosis disease. In this study we aimed to determine the serum levels of interleukin-2 (IL-2) and C-reactive protein (CRP) in patients with tuberculosis and evaluate the relationship with clinical and radiological findings. The study included 60 patients (mean age: 37 ± 12 years, all male) with newly diagnosed pulmonary tuberculosis and 23 healthy controls (mean age: 40 ± 13 years, all male). Admission symptoms, clinical features, demographic data, laboratory investigations and radiological findings were all recorded into the study form. Serum samples which were obtained for determination of IL-2 and CRP levels were preserved at -80°C. While serum IL-2 levels were similar in patients with tuberculosis and healthy controls, serum CRP levels were significantly higher in patients with tuberculosis (p< 0.001). There was a positive correlation between serum IL-2 level and the diameter of cavity (p= 0.012). CRP levels were significantly higher in patients who admitted with fever (p= 0.001) and weight loss (p= 0.024). Serum CRP levels were significantly higher in patients who had involvement of four or more zones (p= 0.029) and multiple cavitary disease (p= 0.001). There was a positive correlation between serum CRP level and the diameter of cavity (p= 0.004). In conclusion, apart from the diameter of cavity, serum IL-2 levels were not correlated with any clinical, laboratory or radiological parameter. Serum CRP levels were a good indicator of disease severity.

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