Acil serviste gastrointestinal sistem kanaması tanısı alan hastalarda serum zonulin düzeyinin araştırılması
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Dosyalar
Tarih
2022
Yazarlar
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dünyada mortalite sebeplerinin önde gelen nedenlerinden biri gastrointestinal sistem kanamalarıdır. Hastaların önemsememesi veya klinik olarak hafif seyreden hastaların hastaneye başvurmaması sebebiyle insidansı kesin olarak bilinmemekle birlikte 100.000 kişide 50-150 gibi yüksek değerde olduğu düşünülmektedir. Gastrointestinal sistem kanaması olan hastaların kliniği ciddi ve mortal sonuçlanabilmektedir. Bu akut patoloji sebebiyle acil servis başvurularında hastalara hızlı tanı koyulup tedaviye başlanmalıdır. Başvuru kliniği halsizlikten ölüme kadar geniş bir yelpazede olması sebebiyle ön tanılara birçok hastalık girmektedir. Klinik tanıdan şüphelenmek ve mortal seyredebilecek bir tablonun tanısını erken koyup tedaviye başlamak son derece önemlidir. Rutin olarak kullanılan laboratuvar testlerinde, gastrointestinal sistem kanamasını gösteren bir parametre bulunmamaktadır. Bu sebeple literatürde bağırsak geçirgenliği ile ilişkilendirilen zonulin biyomarkerının gastrointestinal sistem kanamalarında tanısal değerliliğini araştırmak istedik. Çalışmamız 3. Basamak bir üniversite hastanesinin acil servisinde prospektif ve tek merkezli olarak yapıldı. Çalışmamıza, çalışmaya dahil edilme kriterlerini karşılayan 40 hasta ve 40 kişilik kontrol grubu dahil edildi. Çalışmamızda anlamlılık düzeyi p <0,05 olarak kabul edildi. Çalışmamızda gastrointestinal sistem kanama hastalarının yaş ortalaması 70±13 (medyan 69,5) yıl olarak tespit edildi. Gastrointestinal sistem kanama hasta grubunun %37,5 (n=15)’ i kadın, %62,5 (n=25) ‘i erkek hastalardan oluşmaktaydı. Zonulin düzeyinin hasta olgularda ortalama 22,3±10,5 tespit edilirken, kontrol grubunda 5±2,1 tespit edilmiştir. İstatistik olarak bu bu sonuçlar anlamlı bulunmuştur (p<0,001). Zonulin düzeyleri olguların yaşı ve cinsiyetinden etkilenmediği görüldü. Çalışmamızda elde ettiğimiz veriler zonulinin gastrointestinal sistem kanaması için tanısal bir test olarak kullanılabileceğini düşündürmektedir. Bu çalışma bir ön çalışma olup daha ayrıntılı çalışmaların literatüre bu konuda net bilgi sağlayacağını düşünmekteyiz.
One of the leading causes of mortality in the world is gastrointestinal bleeding. Although the incidence is not known precisely because the patients do not give enough importance or the patients with mild clinical presentation do not apply to the hospital, it is thought to be as high as 50-150 per 100,000 people.Gastrointestinal system bleeding can result in serious and mortal clinical outcomes.Because of this acute pathology, patients should be diagnosed quickly and treatment should be started in emergency service admissions.Many diseases are included in the preliminary diagnoses because the clinic presentation in the admission is in a wide range from fatigue to death.It is extremely important to suspect the clinical presentation and to diagnose a potentially mortal condition early and start treatment. In routine laboratory tests, there is no parameter indicating gastrointestinal bleeding.For this reason, we wanted to investigate the diagnostic value of the zonulin biomarker, which is associated with intestinal permeability in the literature, in gastrointestinal bleeding. Our study was conducted prospectively and in a single center in the emergency department of a tertiary care university hospital.Forty patients who met the inclusion criteria and a control group of 40 people were included in our study.The significance level in our study was accepted as p <0.05. In our study, the mean age of the patients with gastrointestinal bleeding was found to be 70±13 (median 69.5) years.Gastrointestinal system bleeding patient group consisted of 37.5% (n=15) female patients and 62.5% (n=25) male patients.While the mean zonulin level was found to be 22.3±10.5 in the patients, it was determined as 5±2.1 in the control group.These results were statistically significant (p<0.001).Zonulin levels were not affected by the age and gender of the cases. The data we obtained in our study suggest that zonulin can be used as a diagnostic test for gastrointestinal bleeding.As this study is a preliminary study, we think that more detailed studies will provide clear information on this subject to the literature.
One of the leading causes of mortality in the world is gastrointestinal bleeding. Although the incidence is not known precisely because the patients do not give enough importance or the patients with mild clinical presentation do not apply to the hospital, it is thought to be as high as 50-150 per 100,000 people.Gastrointestinal system bleeding can result in serious and mortal clinical outcomes.Because of this acute pathology, patients should be diagnosed quickly and treatment should be started in emergency service admissions.Many diseases are included in the preliminary diagnoses because the clinic presentation in the admission is in a wide range from fatigue to death.It is extremely important to suspect the clinical presentation and to diagnose a potentially mortal condition early and start treatment. In routine laboratory tests, there is no parameter indicating gastrointestinal bleeding.For this reason, we wanted to investigate the diagnostic value of the zonulin biomarker, which is associated with intestinal permeability in the literature, in gastrointestinal bleeding. Our study was conducted prospectively and in a single center in the emergency department of a tertiary care university hospital.Forty patients who met the inclusion criteria and a control group of 40 people were included in our study.The significance level in our study was accepted as p <0.05. In our study, the mean age of the patients with gastrointestinal bleeding was found to be 70±13 (median 69.5) years.Gastrointestinal system bleeding patient group consisted of 37.5% (n=15) female patients and 62.5% (n=25) male patients.While the mean zonulin level was found to be 22.3±10.5 in the patients, it was determined as 5±2.1 in the control group.These results were statistically significant (p<0.001).Zonulin levels were not affected by the age and gender of the cases. The data we obtained in our study suggest that zonulin can be used as a diagnostic test for gastrointestinal bleeding.As this study is a preliminary study, we think that more detailed studies will provide clear information on this subject to the literature.
Açıklama
Anahtar Kelimeler
Biyomarker, Zonulin, Gastrointestinal kanama, Gastrointestinal sistem kanaması, Tanı, Biomarker, Gastrointestinal bleeding, Gastrointestinal system bleeding, Diagnosis
