Kronik hepatit B ve kronik hepatit C'li hastalarda tedavi öncesi ve tedavi sonrası serum neopterin düzeylerinin değerlendirilmesi
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2010
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info:eu-repo/semantics/openAccess
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Kronik hepatit B ve kronik hepatit C infeksiyonlu hastalarda IFN, nükleoz(t)id analogları ve IFN+ribavirin ile tedavi öncesinde ve sonrasında hücresel immün sistem aktivasyon markeri olarak kullanılan neopterin seviyelerinin değerlendirilmesidir.8.2. Gereç ve Yöntem: Çalışma, 49 KHB `li olgu, 30 KHC'li olgu ve 72 sağlıklı birey üzerinde yapıldı. Serum örnekleri tedavi alan hastalardan tedavi başlangıcı ve bitiminde, tedavi almayan hastalar ve kontrol grubundaki sağlıklı bireylerden ise başvuru sırasında alındı.8.3. Bulgular: İnterferon tedavisi alan KHB'li hastaların tedavi öncesi ve sonrası serum NP düzeyleri karşılaştırıldığında tedavi sonrası NP düzeyleri anlamlı olarak yüksek saptandı. Tedaviye yanıt veren 16 hastada tedavi sonrası NP düzeylerinde anlamlı yükseklik saptanırken, tedaviye yanıtsız 6 hastada anlamlı değişiklik saptanmadı. IFN+ribavirin tedavisi verilen KHC'li hastaların tedavi öncesi ve sonrası serum NP düzeyleri karşılaştırıldı. Tedavi sonrası anlamlı yükseklik saptandı. Tedaviye yanıt veren 14 hastada tedavi sonrası NP düzeylerinde anlamlı yükseklik saptanırken, tedaviye yanıtsız 9 hastada anlamlı değişiklik saptanmadı.Kronik hepatit B'li entekavir tedavisi verilen 10 hastanın tedavi öncesi ve sonrası serum NP düzeyleri karşılaştırıldı. İstatistiki olarak anlamlı farklılık saptanmadı.8.4. Sonuç: İnfeksiyonların çoğunda infeksiyon tedavisi öncesi ve sonrasında bir kıyaslama yapıldığında tedavi sonunda immün sistemin aktivasyonu azaldığı için NP düzeylerinde azalma görülmektedir. Fakat immün sistemi uyarıcı bir tedavi olan IFN tedavisi ile hastalık tedavi edildiğinde, tedavi sonunda IFN tedavisine bağlı olarak NP düzeyi yüksek kalmaktadır. İmmün sistemi uyarıcı ilaç verdikten sonra NP düzeyine bakılarak hastalığın tedavi edilip edilmediği hakkında fikir yürütmek mümkün değildir.8.5. Anahtar Kelimeler: Neopterin, KHB, KHC
The aim of this study is to assess the levels of neopterin which is used as an indicator of celluler immune response in the patients with chronic B and C hepatitis before and after IFN and/or nükleoz(t)id analogue therapy.9.2. Material and Methods: This study is accomplished at 49 patients with chronic B hepatitis, 30 patients with chronic C hepatitis and 72 healty individuals. The serum samples were taken from the patients at the beginning and at the end of the therapy, the serum samples of the patients who had not taken therapy and of the healty individuals were taken at the time of admission.9.3. Results: When the serum neopterin levels were compared at the beginning and end of the therapy of chronic B hepatitis patients who had taken IFN therapy the serum neopterin levels at the end of therapy were found significantly higher. Sixteen patients who responded the therapy showed significantly higher levels of neopterin after therapy, 6 patients who did not respond the therapy showed no change. The serum neopterin levels of chronic C hepatitis patients who had taken IFN and ribavirin therapy were compared serum neopterin levels were detected significantly higher at the end of the therapy. In 14 patients who response the therapy significantly higher neopterin levels were detected after therapy and there was not significant change in 9 patients who did not respond the therapy. The serum neopterin levels of 10 chronic B hepatitis patients who had taken ETC therapy was compared before and after therapy. There was not statistically significant difference detected.9.4. Conclusion: When a comparison of neopterin levels was made before and after therapy most of the infections showed reduction at NP levels as the activation of immune system is decreased. When the disease is treated with IFN which stimülate immune system, the serum NP levels remain high dependent to IFN therapy. It is not possible to decide whether the disease is treated or not by looking NP levels after immünostimülant drug.9.5. Key words: Neopterin, CHB, CHC
The aim of this study is to assess the levels of neopterin which is used as an indicator of celluler immune response in the patients with chronic B and C hepatitis before and after IFN and/or nükleoz(t)id analogue therapy.9.2. Material and Methods: This study is accomplished at 49 patients with chronic B hepatitis, 30 patients with chronic C hepatitis and 72 healty individuals. The serum samples were taken from the patients at the beginning and at the end of the therapy, the serum samples of the patients who had not taken therapy and of the healty individuals were taken at the time of admission.9.3. Results: When the serum neopterin levels were compared at the beginning and end of the therapy of chronic B hepatitis patients who had taken IFN therapy the serum neopterin levels at the end of therapy were found significantly higher. Sixteen patients who responded the therapy showed significantly higher levels of neopterin after therapy, 6 patients who did not respond the therapy showed no change. The serum neopterin levels of chronic C hepatitis patients who had taken IFN and ribavirin therapy were compared serum neopterin levels were detected significantly higher at the end of the therapy. In 14 patients who response the therapy significantly higher neopterin levels were detected after therapy and there was not significant change in 9 patients who did not respond the therapy. The serum neopterin levels of 10 chronic B hepatitis patients who had taken ETC therapy was compared before and after therapy. There was not statistically significant difference detected.9.4. Conclusion: When a comparison of neopterin levels was made before and after therapy most of the infections showed reduction at NP levels as the activation of immune system is decreased. When the disease is treated with IFN which stimülate immune system, the serum NP levels remain high dependent to IFN therapy. It is not possible to decide whether the disease is treated or not by looking NP levels after immünostimülant drug.9.5. Key words: Neopterin, CHB, CHC
Açıklama
Anahtar Kelimeler
Hepatit, Hepatit B, Hepatit C virüsü, Neopterine
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Özçimen, S. (2010). Kronik hepatit B ve kronik hepatit C'li hastalarda tedavi öncesi ve tedavi sonrası serum neopterin düzeylerinin değerlendirilmesi.. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Temel Tıp Bilimleri Tıbbi Mikrobiyoloji Anabilim Dalı, Konya.
