Publication: Crohn Hastalarında Hemogram ve Biyokimya Parametrelerinin Analizi ve Hastalık Şiddeti Arasındaki İlişki
Abstract
Amaç: Bu çalışmada Crohn hastalarında hemogram ve laboratuvar parametrelerinin ve bu parametrelerden elde edilen indekslerin hastalık şiddetini öngörmedeki yerini değerlendirmek amaçlandı. Materyal ve metot: Çalışmada Ondokuz Mayıs Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji polikliniğine başvuran 18 yaş ve üstü klinik, endoskopik, histopatolojik ve radyolojik olarak Crohn hastalığı tanısı almış ve hastane veri tabanında aktivite indekslerini hesaplamada kullanılan bilgilerine eksiksiz olarak ulaşılabilen 01/01/2018-01/03/2023 tarihleri arasındaki 90 hasta dahil edildi. Hastalık aktivitesi Crohn Hastalığı Aktivite İndeksi (CHAİ) kullanılarak belirlendi. Hastalar hastalık aktivitelerine göre CHAİ <150 klinik remisyon, 150-220 arasında hafif, 220-450 arasında orta-şiddetli, ˃450 ise şiddetli-fulminan olmak üzere 4 gruba ayrıldı. Hastalarda hemogram ve laboratuvar parametreleri ve bunlardan elde edilen indeksler hesaplandı ve gruplar karşılaştırması yapıldı. Bulgular: Çalışmaya dahil edilen 90 hastanın yaş ortalaması 41,53 ±14,36 olup; 38'i (%42,2) kadın, 52'i (%57,8) erkekti. Hastalık davranış tipine göre hastaların 41'inde (%45,5) inflamatuar, 41'inde (%45,5) fistülizan, 8'inde (%9) stenozan hastalık mevcuttu. Hastalarda en sık ileal tutulum (%43,3) vardı. CHAİ'ye göre hastaların 37'si (%41,1) klinik remisyonda, 10'u (%11,1) hafif ve 43'ü (%47,8) orta-şiddetli aktivitedeydi. CHAİ'ye göre hasta grupları karşılatırıldığında WBC, nötrofil, RDW, platelet, CRP, ESH hastalık şiddetiyle doğru orantılı olarak artış gösterirken; lenfosit, Hb, Htc, MPV, albumin ise hastalık aktivitesi ile ters orantılı olarak azalmaktaydı (p<0,05). Remisyonda ve aktif hastalığı olan hastalar karşılaştırıldığında CRP/albumin, platelet/lenfosit, nötrofil/lenfosit, CRP/lenfosit, platelet/albümin değerlerinde artış saptandı (p<0,05). Sonuç: Crohn hastalığı remisyon, relaps ve alevlenmelerle seyreden kronik inflamatuar bir hastalıktır. Hastalığın şiddetlendiği dönemlerin erken tanınması ve tedavisi oldukça önemlidir. Hastalığın şiddeti ile CRP/albumin, platelet/lenfosit, nötrofil/lenfosit, CRP/lenfosit, platelet/albümin oranı doğru orantılı olarak artmış olduğu bulundu. Hastalık şiddeti ve aktivasyonunun değerlendirilmesinde noninvaziv bu indekslerinin maliyet etkin inflamatuar belirteçler olarak kullanılması yararlı olabilir. Anahtar Kelimeler: Crohn hastalığı, Crohn Hastalığı Aktivasyon İndeksi, Harvey-Bradshaw İndeksi, Hemogram İndeksleri, İnflamasyon İndeksleri
Objective: This study aimed to evaluate the role of hemogram and laboratory parameters and indices obtained from these parameters in predicting disease severity in Crohn's patients. Materials and Methods: In the study, 18 years of age and older who applied to the Gastroenterology outpatient clinic of Ondokuz Mayıs University Faculty of Medicine were diagnosed with Crohn's disease clinically, endoscopically, histopathologically, radiologically and the information used to calculate the activity indexes in the hospital database can be accessed in full between by 01/01/2018-01/03/2023, 90 patients were included. Disease activity was determined using the Crohn's Disease Activity Index (CHAI). Patients were divided into 4 groups according to their disease activity; CHAI <150 as clinical remission, 150-220 as mild, 220-450 as moderate-severe, and ˃450 as severe-fulminant. Hemogram and laboratory parameters of the patients and the indices obtained from them were calculated and the groups were compared. Results: The average age of the 90 patients included in the study was 41.53 ±14.36; 38 (42.2%) were women and 52 (57.8%) were men. According to the disease behavior type, 41 (45.5%) patients had inflammatory, 41 (45.5%) fistulizing, and 8 (9%) stenosing disease. The most common disease in patients was ileal involvement (43.3%). According to the CHAI, 37 (41.1%) of the patients were in clinical remission, 10 (11.1%) were in mild activity, and 43 (47.8%) were in moderate-vigorous activity. When the patient groups are compared according to CHAI, WBC, neutrophil, RDW, platelet, CRP, ESR increase in direct proportion to the severity of the disease; lymphocyte, Hb, Htc, MPV and albumin were decreasing inversely proportional to disease activity (p<0.05). When patients in remission and those with active disease were compared, an increase was detected in CRP/albumin, platelet/lymphocyte, neutrophil/lymphocyte, CRP/lymphocyte, platelet/albumin values (p<0.05). Conclusion: Crohn's disease is a chronic inflammatory disease that progresses with remissions, relapses and exacerbations. Early recognition and treatment of the disease exacerbation is very important. It was found that the CRP/albumin, platelet/lymphocyte, neutrophil/lymphocyte, CRP/lymphocyte, platelet/albumin ratio increased in direct proportion to the severity of the disease. It may be useful to use these noninvasive indices as cost-effective inflammatory markers in the evaluation of disease severity and activation. Keywords: Crohn's disease, Crohn's Disease Activation Index, Harvey-Bradshaw Index, Hemogram Indices, Inflammation Indices
Objective: This study aimed to evaluate the role of hemogram and laboratory parameters and indices obtained from these parameters in predicting disease severity in Crohn's patients. Materials and Methods: In the study, 18 years of age and older who applied to the Gastroenterology outpatient clinic of Ondokuz Mayıs University Faculty of Medicine were diagnosed with Crohn's disease clinically, endoscopically, histopathologically, radiologically and the information used to calculate the activity indexes in the hospital database can be accessed in full between by 01/01/2018-01/03/2023, 90 patients were included. Disease activity was determined using the Crohn's Disease Activity Index (CHAI). Patients were divided into 4 groups according to their disease activity; CHAI <150 as clinical remission, 150-220 as mild, 220-450 as moderate-severe, and ˃450 as severe-fulminant. Hemogram and laboratory parameters of the patients and the indices obtained from them were calculated and the groups were compared. Results: The average age of the 90 patients included in the study was 41.53 ±14.36; 38 (42.2%) were women and 52 (57.8%) were men. According to the disease behavior type, 41 (45.5%) patients had inflammatory, 41 (45.5%) fistulizing, and 8 (9%) stenosing disease. The most common disease in patients was ileal involvement (43.3%). According to the CHAI, 37 (41.1%) of the patients were in clinical remission, 10 (11.1%) were in mild activity, and 43 (47.8%) were in moderate-vigorous activity. When the patient groups are compared according to CHAI, WBC, neutrophil, RDW, platelet, CRP, ESR increase in direct proportion to the severity of the disease; lymphocyte, Hb, Htc, MPV and albumin were decreasing inversely proportional to disease activity (p<0.05). When patients in remission and those with active disease were compared, an increase was detected in CRP/albumin, platelet/lymphocyte, neutrophil/lymphocyte, CRP/lymphocyte, platelet/albumin values (p<0.05). Conclusion: Crohn's disease is a chronic inflammatory disease that progresses with remissions, relapses and exacerbations. Early recognition and treatment of the disease exacerbation is very important. It was found that the CRP/albumin, platelet/lymphocyte, neutrophil/lymphocyte, CRP/lymphocyte, platelet/albumin ratio increased in direct proportion to the severity of the disease. It may be useful to use these noninvasive indices as cost-effective inflammatory markers in the evaluation of disease severity and activation. Keywords: Crohn's disease, Crohn's Disease Activation Index, Harvey-Bradshaw Index, Hemogram Indices, Inflammation Indices
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