Astımlı hastalarımızın klinik ve laboratuvar özellikleri ve bunları etkileyen faktörler
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Dosyalar
Tarih
2003
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çocuk İmmünoloji ve Allerji polikliniğimizde Eylül 2001 -Mart 2003 tarihleri arasında astım tanısı ile takip edilen toplam 486 hastanın klinik ve laboratuar özelliklerini ve bunları etkileyen faktörleri belirlemek amacıyla dosya kayıtlan incelendi. Astımlı hastaların % 37'si 4 yaş ve altındayken, % 63'ü 5 yaş ve üzerinde idi. 4 yaş ve altında erkek hasta sayısı astımlı kız hastaların yaklaşık 2 katı idi (p<0,05). Hastaların %80'i şehirde yaşıyordu ve %73,6'sında astım şikayetleri 5 yaşın altında başlamıştı. En sık başvuru şikayeti öksürük olup (%64,4) sık enfeksiyon öyküsü hastaların %52,9'unda alındı. Hastaların %7,2'si düşük doğum ağırlıklı ve %20,5'u sezeryanla doğmuştu. Ailesinde atopik hastalık öyküsü hastalarımızın %39,7'sinde saptanırken ebeveynlerin evde sigara içme oranı %48,5 evde hayvan besleme oram ise %7,6 olarak bulundu. Epidermal deri testinde en az bir allerjene duyarlılık oram %51,2 iken birden fazla allerjene duyarlılık % 23,5 oranında saptandı. Atopik astımlı hastalarımızda duyarlarıma sıklığı sırasıyla ev tozu akan (%51,4), polen (%50,01), hayvan tüyü (%14,3), küf (%6,9), inek sütü, (%3,5) yumurta, (%3,1) ve kakao (%1,9) allerjisi şeklindeydi. Astıma hastalarımızın %33'ünde allerjik rinit, % 17,2'sinde atopik dermatit, %7'sinde adenoid vejetasyon, %8,2'sinde gastroözefageal reflü eşlik ediyordu. Başvuru anında astımlı hastaların Akciğer grafisinde %46 sinüs grafisinde %33,9 oranında anormallik vardı. Serum total IgE yüksekliği hastaların %48'inde ve periferik kanda eozinofili hastaların %24' ünde saptandı. Adenoid vejetasyonun atopik hastalarda daha fazla geliştiği saptandı. Eşlik eden diğer hastalıklarla atopi arasında ilişki saptanmadı Astımlı hastalarda ailede atopik hastalık öyküsü varlığı ile atopi arasında istatistiksel olarak anlamlı ilişki saptandı (p<0,05). Astımlı hastalarda yaş ile birlikte atopi oranının arttığı, ancak 4 yaş ve altı grup ile 5 yaş üstü grup arasında atopi sıklığı yönünden istatistiksel olarak fark olmadığı saptandı (p>0,05). Beş yaş altında atopik dermatit ve gaströzafageal reflünün, 5 yaş üstünde ise allerjik rinit, ev tozu akan ve polenlere karşı duyarlanmanın daha fazla olduğusaptandı (p<0,05). Astımlı kız hastalarda, parsiyel Ig A eksikliği ve allerjik rinit oranı yüksek bulunurken, erkek 62hastalarda ev tozu akan duyarlılığı (Dp) küf ve yumurta allerjisi daha sık saptandı (p<0,05). Sonuç olarak bölgemizde atopi için şehirde yaşam ve ailede atopi öyküsünün önemli bir risk faktörü olduğu (p<0,05) ve allerjen duyarlılığında en sık ev tozu akarı ve polenlerin rol oynadığı, evde sigara içilmesi ve evde hayvan beslemenin astım için risk faktörü olmadığı saptandı. (p>0,05). Konya ile çevre iller ve Konya'ya bağlı ilçeler arasında atopi sıklığı, allerjen cinsi ve duyarlanma oranlan arasında fark olmadığı tespit edildi (p>0,05). Olgularımızın atopi oram, ülkemizdeki diğer çalışmalarda bildirilen oranlardan düşüktü ve bu durum çalışma grubumuzun yaşlarının düşük olmasına bağlandı.
The records of a total of 486 patients who were followed up in our Pediatric Immunology and Allergy Department with a diagnose of bronchial asthma from September 2001 to March 2003 were investigated retrospectively. Thirty-seven percent of the patients with asthma were four years of age and under while 63.0% of the patients were five years of age and over. The number of male patients with asthma under four years was approximately twice as many as that of the female patients (P<0.05). Eighty percent of the patients were living in urban areas and the complaints related to asthma had begun before five years old in 73.6% of the patients. The most common complaint was cough (64.4%) and a history of frequent infection was present in 52.9% of the patients. The ratio of patients who were born with low birth weight was7,2 % (SGA=small for gestational age ) and 20,5% of the patients were delivered by sectio. Familial history of atopy was detected in39,7% of our patients while the parental smoking ratio was 48,5%; and the ratio of having domestic animals was found as 7,6%. In skin prick test, the ratio of sensitisation to at least one allergen (atopy) was 51,2% while that of more than one allergen was 37.7%. In our atopic patients the frequencies of sensitisations were as follows: house-dust mite (51,4%), pollens (50,0%), animal feathers (14,3%), mould (6,9%), cow's milk (3,5%), egg proteins (3,1%) and cocoa (%1,9). In asthmatic patients, the accompanying diseases were as follow: allergic rhinitis33,0%; atopic dermatitis 17,2%; adenoid vegetation 7,0% and gastroesophagial reflux 8,2%. At the time of admission, patients with asthma had 46,0% of chest X-rays and 33,9% of sinus X-rays with abnormal findings. An elevated serum total IgE level was found in 48,0%; and eosinophilia in peripheral blood was found in 24,0% of the patients. It was found out that the adenoid vegetation was more prevalent in atopic patients. In atopic patients, a statistically significant relationship between the history of familial atopic disorders and atopy was found (P<0.05). It was discovered that the incidence of atopy in asthmatic patients, increased by age, but there were no statistically significant differences in the frequency of atopy between the group of patients under and in four years of age and the group of patients over five years of age (P>0.05). It was discovered that atopic dermatitis and gastroesophageal reflux were more common under 5 years of age, and allergic rhinitis, and sensitisation to house- dust mites and pollens was more prevalent over 5 years of age (P<0.05). In asthmatic female patients, the ratios of mould allergy, partial IgA deficiency and allergic rhinitis were found higher, while in male patients house-dust mite (Dp) sensitisation and allergy to egg proteins were more frequent (P<0.05). As a result, we found that in our region living in urban areas and history of familial atopy is an important risk factor for atopy (P<0.05). In the sensitisation to allergens, house-dust mites and pollens play a major role; while parental smoking and having domestic animals at home are not risk factors for astma (P>0.05). It was discovered that there were no differences in frequencies of atopy, types of allergens and ratios of sensitisation between Konya and surrounding cities and the countries of Konya (P>0.05). The ratio of having atopy in our cases was lower than those of other studies reported in our country and this was attributable to having a younger age group in our study.
The records of a total of 486 patients who were followed up in our Pediatric Immunology and Allergy Department with a diagnose of bronchial asthma from September 2001 to March 2003 were investigated retrospectively. Thirty-seven percent of the patients with asthma were four years of age and under while 63.0% of the patients were five years of age and over. The number of male patients with asthma under four years was approximately twice as many as that of the female patients (P<0.05). Eighty percent of the patients were living in urban areas and the complaints related to asthma had begun before five years old in 73.6% of the patients. The most common complaint was cough (64.4%) and a history of frequent infection was present in 52.9% of the patients. The ratio of patients who were born with low birth weight was7,2 % (SGA=small for gestational age ) and 20,5% of the patients were delivered by sectio. Familial history of atopy was detected in39,7% of our patients while the parental smoking ratio was 48,5%; and the ratio of having domestic animals was found as 7,6%. In skin prick test, the ratio of sensitisation to at least one allergen (atopy) was 51,2% while that of more than one allergen was 37.7%. In our atopic patients the frequencies of sensitisations were as follows: house-dust mite (51,4%), pollens (50,0%), animal feathers (14,3%), mould (6,9%), cow's milk (3,5%), egg proteins (3,1%) and cocoa (%1,9). In asthmatic patients, the accompanying diseases were as follow: allergic rhinitis33,0%; atopic dermatitis 17,2%; adenoid vegetation 7,0% and gastroesophagial reflux 8,2%. At the time of admission, patients with asthma had 46,0% of chest X-rays and 33,9% of sinus X-rays with abnormal findings. An elevated serum total IgE level was found in 48,0%; and eosinophilia in peripheral blood was found in 24,0% of the patients. It was found out that the adenoid vegetation was more prevalent in atopic patients. In atopic patients, a statistically significant relationship between the history of familial atopic disorders and atopy was found (P<0.05). It was discovered that the incidence of atopy in asthmatic patients, increased by age, but there were no statistically significant differences in the frequency of atopy between the group of patients under and in four years of age and the group of patients over five years of age (P>0.05). It was discovered that atopic dermatitis and gastroesophageal reflux were more common under 5 years of age, and allergic rhinitis, and sensitisation to house- dust mites and pollens was more prevalent over 5 years of age (P<0.05). In asthmatic female patients, the ratios of mould allergy, partial IgA deficiency and allergic rhinitis were found higher, while in male patients house-dust mite (Dp) sensitisation and allergy to egg proteins were more frequent (P<0.05). As a result, we found that in our region living in urban areas and history of familial atopy is an important risk factor for atopy (P<0.05). In the sensitisation to allergens, house-dust mites and pollens play a major role; while parental smoking and having domestic animals at home are not risk factors for astma (P>0.05). It was discovered that there were no differences in frequencies of atopy, types of allergens and ratios of sensitisation between Konya and surrounding cities and the countries of Konya (P>0.05). The ratio of having atopy in our cases was lower than those of other studies reported in our country and this was attributable to having a younger age group in our study.
Açıklama
Anahtar Kelimeler
Astım, Asthma, Alerji, Allergy
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yüksekkaya, H. A. (2003). Astımlı hastalarımızın klinik ve laboratuvar özellikleri ve bunları etkileyen faktörler. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Konya.
