ÖZ
Amaç
Entamoeba histolytica, akut gastroenteritlerin önde gelen paraziter etkenlerinden biridir. Bu çalışmada, adezin pozitif amoebiasis olgularında hematolojik enflamatuvar indeksler değerlendirilmiştir.
Yöntemler
Ocak 2022-Aralık 2023 tarihleri arasında Necmettin Erbakan Üniversitesi Tıp Fakültesi, Tıbbi Parazitoloji laboratuvarına amibiyazis şüphesi ile gönderilen ve Entamoeba histolytica spesifik adezin enzim bağlı immünosorbent analiz testi pozitif bulunan hastalarda adezin test sonuçları ve hemogram parametreleri eş zamanlı olarak değerlendirilmiştir. Bu çalışmada, indeksler hemogram parametreleri kullanılarak hesaplanmıştır. Adezin testi pozitif akut gastroenterit (APAG) ve adezin testi negatif akut gastroenterit (ANAG) hastalarından oluşan, yaş ve cinsiyet açısından eşleştirilmiş gruplar oluşturulmuştur. Genel istatistiksel analizlere ek olarak, çeşitli hematolojik enflamatuvar parametrelerin adezin pozitifliğini öngörmedeki tanısal performansı alıcı işletim karakteristiği analizi ile değerlendirilmiştir.
Bulgular
Çalışmada 136’sı 18 yaş altı olmak üzere 340 hastanın sonucu incelenmiştir. APAG grupta kan lenfosit ve monosit düzeyleri ANAG gruba göre anlamlı olarak (p=0,004, p=0,048, sırasıyla) düşük bulunurken, kalan hemogram parametrelerinde farklılığa rastlanmamıştır. C-reaktif protein düzeyinde de istatistiksel olarak fark tespit edilmemiştir (p=0,061). Platelet lenfosit oranı (PLR) indeksinde iki grup arasındaki fark anlamlı bulunurken (p=0,017) diğer indekslerde gruplar arasında anlamlı farklılık saptanmamıştır. APAG grubunun cinsiyete dayalı alt grup analizinde, kırmızı kan hücresi seviyeleri kadın hastalarda daha düşük bulunurken (p=0,026), hesaplanan diğer indekslerde anlamlı bir farklılık gözlenmemiştir.
Sonuç
Bu çalışmada, çeşitli hematolojik enflamatuvar parametrelerin adezin pozitifliğini öngörme performansları değerlendirilmiştir. Her ne kadar PLR indeksinde gruplar arası fark saptansa da genel olarak tüm parametrelerde pozitif ve negatif prediktif değerler orta düzeyde kalmaktadır. Bu sebeple, söz konusu biyobelirteçlerin tanısal performansının kısıtlı olduğu sonucuna varılmıştır.
Anahtar Kelimeler:
Amibiyazis, adezin test, SIRI, PLR, NLR
Kaynaklar
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