Behçet hastalığında klinik aktivasyon ile CRP/albümin ve fibrinojen/albümin arasındaki ilişki
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Tarih
2022
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Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Behçet hastalığı etyolojisi tam olarak bilinmeyen kronik, ataklarla seyreden küçük, orta ve büyük tüm damarları tutabilen bir sistemik vaskülit tablosudur. Behçet hastalığı remisyon ve ataklarla seyretmesi nedeniyle hastalık aktivitesini tek bir belirteçle değerlendirmek mümkün değildir. Hastalık aktivitesi ile korele, hızlı, kolay uygulanabilir belirteçlere ihtiyaç vardır. Literatürde Behçet hastalığı aktivitesi ile CRP/albümin(CAO) ve Fibrinojen/albümin(FAO) ilişkisini araştıran bir çalışmaya rastlanmamıştır. Çalışmamızda, aktif Behçet hastaları, inaktif Behçet hastaları ve kontrol grubunun CRP/albümin ve Fibrinojen/albümin değerleri karşılaştırılarak bu değerlerin Behçet hastalığı aktivitesiyle ilişkisini ve Behçet hastalarını sağlıklı erişkinlerden ayırt etmedeki üstünlüğünü değerlendirmeyi amaçladık. Çalışmadaki esas amacımız Behçet hastalığı aktivitesi ile CRP/albümin ve Fibrinojen/albümin değerlerinin korelasyonunu ortaya koymaktır. Gereç ve Yöntem Çalışmaya Deri ve Zührevi Hastalıkları polikliniğine başvuran ve Uluslararası Çalışma Grubu kriterlerine göre Behçet hastalığı tanısı almışaktif veya inaktif dönemde takip edilen 18 yaş ve üzeri 62 hasta prospektif olarak dahil edildi. Kontrol grubuna aynı polikliniğe inflamatuar olmayan dermatolojik lezyonlar ile başvuran bilinen kronik bir hastalığı olmayan yaş, cinsiyet, VKİ uyumlu 18 yaş ve üzeri sağlıklı gönüllülerden oluşan 28 kişi dahil edildi. Çalışmada yer alan olguların demografik özellikleri, aile öyküsü,Behçet hastalığı klinik bulguları, başvuru esnasındaki hastalık aktiviteleri ile Behçet hastalarından ve kontrol grubundan alınan kan sonuçları kaydedildi. Başvuru anındaki numunelerden hemogram, CRP, fibrinojen, albümin ve rutin kontrol amaçlı alınan örnekler değerlendirildi. Behçet hastalarının başvuru esnasındaki hastalık aktivitesi BDCAF göre belirlendi. Total indeks skoru 0-12 arasında hesaplandı, 4 ve 4'ten yüksek skorlar aktif, 4'ten düşük skorlar inaktif kabul edilerek 2 gruba ayrıldı. Bulgular Çalışmaya alınan olguların 62'si Behçet hastaları ve 28'i kontrol grubuydu. Behçet hastalarının 30'u aktif ve 32'si inaktif dönemdeydi. Olguların yaş ortalaması 38,62±10,48 idi. Behçet hastalarındaki ortalama CAO seviyesi (0,218±0,400), kontrol grubundaki CAO seviyesine (0,049±0,045) kıyasla anlamlı yüksek saptandı (p=0,015). Aktif Behçet hastalarının CAO değeri, kontrol grubundan daha yüksekti (p=0,013). Ancak diğer grupların CAO değerleri arasında istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Behçet hastalarındaki ortalama FAO seviyesi ( 7,471±2,413 ) kontrol grubundaki FAO seviyesine ( 5,623±1,261 ) kıyasla anlamlı yüksek saptandı (p=0,001). Aktif ve inaktif Behçet hastalarının FAO değeri, kontrol grubundan daha yüksekti (sırasıyla p=0,001; p=0,020). Ancak aktif ve inaktif Behçet hastalarının FAO değerleri arasında istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Eritema nodozum benzeri lezyonu ve artriti olan Behçet hastalarında bu bulguları olmayanlara kıyasla CAO değerinde anlamlı farklılık saptandı(sırasıyla p=0,024 , p=0,006). Eritema nodozum benzeri lezyon ve artrit görülen Behçet hastalarında CAO değeri daha yüksek bulundu. Oral ülser ve artriti olan Behçet hastalarında bu bulguları olmayanlara kıyasla FAO değerinde anlamlı farklılık saptandı(sırasıyla p=0,015, p=0,038). Oral ülser ve artrit görülen Behçet hastalarında FAO değeri daha yüksek bulundu. Sonuç Behçet hastalığının tanısını koymak ve aktivitesini belirleyebilmek için kullanılan çok çeşitli laboratuvar parametreleri bulunmaktadır. Bazıları Behçet hastalığının belirli klinik bulgularıyla ilişkilendirilirken bazıları da aktif hastalık döneminde yükselmektedir. Klinisyene yardımcı spesifik bir parametre olmaması tanı ve tedavide gecikmelere yol açmaktadır. Çalışmamızda kolay, hızlı hesaplanabilir, ucuz ve tedavi altındaki hastalarda dahi yol gösterici olabilecek CRP/albümin ve Fibrinojen/albümin değerlerinin hastalık tanısında ve aktivitesindeki rolünü araştırmayı amaçladık.
Behçet's disease is a chronic, relapsing systemic vasculitis of unknown etiology that can involve all small, medium and large vessels. Since Behçet's disease progresses with remissions and attacks, it is not possible to evaluate disease activity with a single marker. There is a need for rapid, easily applicable markers that correlate with disease activity. There is no study in the literature investigating the relationship between Behçet's disease activity and CRP/albumin (CAO) and Fibrinogen/albumin (FAO). In our study, we aimed to compare the CRP/albumin and Fibrinogen/albumin values of active Behçet's patients, inactive Behçet's patients and the control group, and to evaluate the relationship of these values with Behçet's disease activity and their superiority in distinguishing Behçet's patients from healthy adults. Our main aim in the study is to reveal the correlation between Behçet's disease activity and CRP/albumin and Fibrinogen/albumin values. Materials and Methods 62 patients aged 18 years and over, who applied to the Dermatology and Venereal Diseases outpatient clinic and were diagnosed with Behçet's disease according to the criteria of the International Working Group, were included in the study, in the active or inactive period. The control group included 28 healthy volunteers aged 18 years and over, who did not have a known chronic disease, who applied to the same polyclinic with non-inflammatory dermatological lesions, and were matched for age, gender, and BMI. Demographic characteristics, family history, clinical findings of Behçet's disease, disease activities at the time of admission, and blood results from Behçet's patients and the control group were recorded. Hemogram, CRP, fibrinogen, albumin and routine control samples were evaluated from the samples at the time of application. Disease activity of Behçet's patients at admission was determined according to BDCAF. Total index score was calculated between 0-12, scores higher than 4 and 4 were considered active, and scores lower than 4 were considered inactive and divided into 2 groups. Results Of the cases included in the study, 62 were Behçet's patients and 28 were in the control group. 30 of Behçet's patients were active and 32 were inactive. The mean age of the cases was 38.62±10.48 years. The mean CAO level in Behçet's patients (0.218±0.400) was found to be significantly higher than the CAO level in the control group (0.049±0.045) (p=0.015). The CAO value of active Behçet's patients was higher than the control group (p=0.013). However, no statistically significant difference was found between the CAO values of the other groups (p>0.05). The mean FAO level in Behçet's patients ( 7,471±2,413 ) was found to be significantly higher than the FAO level in the control group ( 5,623±1,261 ) (p=0,001). The FAO value of active and inactive Behçet's patients was higher than the control group (p=0.001; p=0.020, respectively). However, no statistically significant difference was found between the FAO values of active and inactive Behçet's patients (p>0.05). There was a significant difference in CAO value in Behçet's patients with erythema nodosum-like lesion and arthritis compared to those without these findings (p=0.024 , p=0.006, respectively). CAO value was found to be higher in Behçet's patients with erythema nodosum-like lesion and arthritis. A significant difference was found in the FAO value in Behçet's patients with oral ulcers and arthritis compared to those without these findings (p=0.015, p=0.038, respectively). The FAO value was found to be higher in Behçet's patients with oral ulcer and arthritis. Conclusion There are a wide variety of laboratory parameters used to diagnose Behçet's disease and to determine its activity. Some of them are associated with certain clinical findings of Behçet's disease, while others increase during active disease. The lack of a specific parameter that helps the clinician causes delays in diagnosis and treatment. In our study, we aimed to investigate the role of CRP/albumin and Fibrinogen/albumin values in the diagnosis and activity of the disease, which is easy, fast to calculate, inexpensive and can be a guide even in patients under treatment.
Behçet's disease is a chronic, relapsing systemic vasculitis of unknown etiology that can involve all small, medium and large vessels. Since Behçet's disease progresses with remissions and attacks, it is not possible to evaluate disease activity with a single marker. There is a need for rapid, easily applicable markers that correlate with disease activity. There is no study in the literature investigating the relationship between Behçet's disease activity and CRP/albumin (CAO) and Fibrinogen/albumin (FAO). In our study, we aimed to compare the CRP/albumin and Fibrinogen/albumin values of active Behçet's patients, inactive Behçet's patients and the control group, and to evaluate the relationship of these values with Behçet's disease activity and their superiority in distinguishing Behçet's patients from healthy adults. Our main aim in the study is to reveal the correlation between Behçet's disease activity and CRP/albumin and Fibrinogen/albumin values. Materials and Methods 62 patients aged 18 years and over, who applied to the Dermatology and Venereal Diseases outpatient clinic and were diagnosed with Behçet's disease according to the criteria of the International Working Group, were included in the study, in the active or inactive period. The control group included 28 healthy volunteers aged 18 years and over, who did not have a known chronic disease, who applied to the same polyclinic with non-inflammatory dermatological lesions, and were matched for age, gender, and BMI. Demographic characteristics, family history, clinical findings of Behçet's disease, disease activities at the time of admission, and blood results from Behçet's patients and the control group were recorded. Hemogram, CRP, fibrinogen, albumin and routine control samples were evaluated from the samples at the time of application. Disease activity of Behçet's patients at admission was determined according to BDCAF. Total index score was calculated between 0-12, scores higher than 4 and 4 were considered active, and scores lower than 4 were considered inactive and divided into 2 groups. Results Of the cases included in the study, 62 were Behçet's patients and 28 were in the control group. 30 of Behçet's patients were active and 32 were inactive. The mean age of the cases was 38.62±10.48 years. The mean CAO level in Behçet's patients (0.218±0.400) was found to be significantly higher than the CAO level in the control group (0.049±0.045) (p=0.015). The CAO value of active Behçet's patients was higher than the control group (p=0.013). However, no statistically significant difference was found between the CAO values of the other groups (p>0.05). The mean FAO level in Behçet's patients ( 7,471±2,413 ) was found to be significantly higher than the FAO level in the control group ( 5,623±1,261 ) (p=0,001). The FAO value of active and inactive Behçet's patients was higher than the control group (p=0.001; p=0.020, respectively). However, no statistically significant difference was found between the FAO values of active and inactive Behçet's patients (p>0.05). There was a significant difference in CAO value in Behçet's patients with erythema nodosum-like lesion and arthritis compared to those without these findings (p=0.024 , p=0.006, respectively). CAO value was found to be higher in Behçet's patients with erythema nodosum-like lesion and arthritis. A significant difference was found in the FAO value in Behçet's patients with oral ulcers and arthritis compared to those without these findings (p=0.015, p=0.038, respectively). The FAO value was found to be higher in Behçet's patients with oral ulcer and arthritis. Conclusion There are a wide variety of laboratory parameters used to diagnose Behçet's disease and to determine its activity. Some of them are associated with certain clinical findings of Behçet's disease, while others increase during active disease. The lack of a specific parameter that helps the clinician causes delays in diagnosis and treatment. In our study, we aimed to investigate the role of CRP/albumin and Fibrinogen/albumin values in the diagnosis and activity of the disease, which is easy, fast to calculate, inexpensive and can be a guide even in patients under treatment.
Açıklama
Anahtar Kelimeler
Behçet hastalığı, CRP/albümin, Fibrinojen/albümin, Klinik aktivasyon, Behçet's disease, CRP/albumin, Fibrinogen/albumin, Clinical activation
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Işık, B. (2022). Behçet hastalığında klinik aktivasyon ile CRP/albümin ve fibrinojen/albümin arasındaki ilişki. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Deri ve Zührevi Hastalıklar Anabilim Dalı, Konya.
