Enfeksiyöz ve non enfeksiyöz gastroenteritlerde serum zonulin düzeyinin araştırılması
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Dosyalar
Tarih
2022
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dünyada morbidite ve mortalitenin önemli sebeplerinden biri olan gastroenteritler, sağlık harcamalarında da ciddi yer kaplarlar. Dünya Sağlık Örgütü verilerine göre dünyada yıllık insidansı 2 milyar olduğu düşünülmektedir. Yine dünya genelinde her yıl 2.2 milyon insanın gastroenteri sebebiyle öldüğü bildirilmiştir. Gastroenterit hastalarının en sık ölüm sebebi dehidratasyon ve dehidratasyona bağlı elektrolit bozuklukları ile asidozken, enfektif gastroenteritlerde bunlara ek etkene bağlı komplikasyonlarda olabilmektedir. Her iki gastroenterit grubunda da öncelikli tedavi dehidratasyon tedavisiyken invaziv gastroenterit grubunda antibiyoterapide tedaviye eklenmelidir. İnvaziv ve noninvaziv gastroenterit ayrımı kolay yapılamaması ve sonuçların erken çıkmaması sebebiyle hastalar ya gereksiz antibiyoterapi almakta ya da tedaviye başlanmada geç kalınmaktadır. Acil servis kliniklerinde yaşanan bu sorunu çözmek amacıyla bağırsak geçirgenliğini düzenleyen zonulin biyobelirtecinin invaziv gastroenterit ayrımında tanısal değerini araştırmak istedik. Çalışmamız 3. Basamak bir üniversite hastanesinin acil servisinde prospektif ve tek merkezli olarak yapıldı. Çalışmamıza, çalışmaya dahil edilme kriterlerini karşılayan 25 invaziv gastroenterir hastası, 25 noninvaziv gastroenterit hastası ve 25 kişilik kontrol grubu dahil edildi. Çalışmamızda anlamlılık düzeyi p <0,05 olarak kabul edildi. Çalışmamızda enfeksiyöz gastroenterit tanılı hastaların ortanca yaşı 33, nonenfeksiyöz gastroenterit tanılı hastaların 40, kontrol grubundaki sağlıklı bireylerin ise 28 tespit edildi. Çalışmadaki toplam 75 kişinin %54,7 (41)’si kadındı. Enfeksiyöz gastroenterit grubunda bulunan kişilerin %64 (16)’ü, non-enfeksiyöz gastroenterit hastalarının %40 (10)’ı ve kontrol grubundaki kişilerin %60 (15)’ı kadın hastalardan oluşmaktaydı. Zonulin düzeyi invaziv gastroenterit olgularında ortalama 23,4±9,8, noninvaziv gastroenterit olgularında 19,5±3,9 tespit edilirken, kontrol grubunda 3,6±1,4 tespit edilmiştir. Hasta gruplarının bu sonuçları kontrol grubuna göre istatistiksel anlamlı bulunmuştur (p<0,001). Zonulin düzeyleri hastaların yaş ve cinsiyetinden etkilenmediği görüldü. Çalışmamızda zonulinin gastroenterit tanısında tanısal bir test olarak kullanılabileceği ancak, invaziv ve noninvaziv gastroenterit ayrımını yapmada kullanılamayacağı tespit edildi. Bu çalışma bir ön çalışma olup daha ayrıntılı çalışmaların literatüre bu konuda net bilgi vereceğini düşünmekteyiz.
Gastroenteritis plays a serious role in morbidity and mortality as well as health expenses. Annual incidence is thought to be 2 billion according to data from World Health Organization. It is reported that each year, 2.2 million people die because of gastroenteritis. Most common cause of death in gastroenteritis patients is dehydration, electrolyte deformities due to dehydration and acidosis. In infective gastroenteritis patients, there may be additional complications dependent on the factors. In both gastroenteritis groups, preferential treatment is dehydration treatment but antibiotic therapy should also be added in invasive gastroenteritis group. Patients cannot begin taking their antibiotics therapy or treatments in time because it is not easy to determine whether it is invasive or non-invasive gastroenteritis and the results do not come up early enough. In order to solve this problem in the Emergency Room, we wanted to research the diagnostical value of intestinal permeability regulating zonulin biomarker in discriminating invasive gastroenteritis. Our study was conducted in a tertiary university hospital’s emergency room in prospective and it was monocentric. 25 invasive gastroenteritis patients, 25 non-invasive gastroenteritis patients and 25 people as a control group were included in our study. Significance level is accepted as p<0,05 in our study. In our study, the average age of infectious gastroenteritis diagnosed patients were 33, non-infectious gastroenteritis patients 40, healthy individuals in the control group 28. Of the 75 people in the study, 54.7% (41) were women.64% (16) of the people in the infectious gastroenteritis group, 40% (10) of the non-infectious gastroenteritis group and 60% (15) of the people in the control group consisted of female patients. Average zonulin levels were detected in invasive gastroenteritis cases as23,4±9,8, as 19,5±3,9 in non-invasivegastroenteritiscasesand as 3,6±1,4 in thecontrolgroup. Results of thepatientgroupshavebeendeducted as statisticallymeaningful (p<0,0001). It has been seen that zonulin levels do not get affected from the patient’s ages and sexes. Our study showed that zonulin can be used as a diagnostical test in diagnosing gastroenteritis, however, it cannot be used to discriminate between invasive and non-invasive gastroenteritis. This is a preliminary study, more detailed studies can give more clear information to the literature.
Gastroenteritis plays a serious role in morbidity and mortality as well as health expenses. Annual incidence is thought to be 2 billion according to data from World Health Organization. It is reported that each year, 2.2 million people die because of gastroenteritis. Most common cause of death in gastroenteritis patients is dehydration, electrolyte deformities due to dehydration and acidosis. In infective gastroenteritis patients, there may be additional complications dependent on the factors. In both gastroenteritis groups, preferential treatment is dehydration treatment but antibiotic therapy should also be added in invasive gastroenteritis group. Patients cannot begin taking their antibiotics therapy or treatments in time because it is not easy to determine whether it is invasive or non-invasive gastroenteritis and the results do not come up early enough. In order to solve this problem in the Emergency Room, we wanted to research the diagnostical value of intestinal permeability regulating zonulin biomarker in discriminating invasive gastroenteritis. Our study was conducted in a tertiary university hospital’s emergency room in prospective and it was monocentric. 25 invasive gastroenteritis patients, 25 non-invasive gastroenteritis patients and 25 people as a control group were included in our study. Significance level is accepted as p<0,05 in our study. In our study, the average age of infectious gastroenteritis diagnosed patients were 33, non-infectious gastroenteritis patients 40, healthy individuals in the control group 28. Of the 75 people in the study, 54.7% (41) were women.64% (16) of the people in the infectious gastroenteritis group, 40% (10) of the non-infectious gastroenteritis group and 60% (15) of the people in the control group consisted of female patients. Average zonulin levels were detected in invasive gastroenteritis cases as23,4±9,8, as 19,5±3,9 in non-invasivegastroenteritiscasesand as 3,6±1,4 in thecontrolgroup. Results of thepatientgroupshavebeendeducted as statisticallymeaningful (p<0,0001). It has been seen that zonulin levels do not get affected from the patient’s ages and sexes. Our study showed that zonulin can be used as a diagnostical test in diagnosing gastroenteritis, however, it cannot be used to discriminate between invasive and non-invasive gastroenteritis. This is a preliminary study, more detailed studies can give more clear information to the literature.
Açıklama
Anahtar Kelimeler
Belirteç, İnvaziv gastroenterit, Noninvaziv gastroenterit, Tanı, Zonulin, Biomarker, Diagnosis, Invasive gastroenteritis, Non-invasive gastroenteritis
