Tıkanma ikterinde idrarda nitrit pozitifliği
Yükleniyor...
Dosyalar
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Safra yollarının herhangi bir seviyesinde, hastalıklara bağlı olarak gelişen kısmi veya tam tıkanıklık sonucu safra akışının engellenmesi sonucu cilt , sklera ve müköz membranlarda oluşan sarılık tablosuna tıkanma ikteri denir (1). Sıvı desteği ve antibiyotik tedavisine yanıt veren basit bir enfeksiyondan, organ yetmezlikleri ile sonuçlanabilen ağır bir enfeksiyona kadar farklı kliniklerde karşımıza çıkabilen bu tablo erken dönemde fark edilip uygun tıbbi tedavi uygulanmadığı takdirde yüksek mortalite ile seyredebilmektedir (2). Normal idrarda nitrit negatiftir. İdrarda nitrit pozitifliğinin en sık sebebi nitrat redüktaz enzimi içeren bakteriyel patojenlerle üriner sistem enfeksiyonudur. Biz çalışmamızda üriner enfeksiyon bulgusu olmayan tıkanma ikteri tanılı hastalarda idrarda nitrit atılımını kontrol grubu ile karşılaştırmalı olarak incelemeyi amaçladık. Metot: Çalışmamıza Selçuk Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji Bilim Dalı'nda 18-65 yaş arası 60 tıkanma ikteri nedeniyle takipli hasta, 60 kontrol grubu olmak üzere toplam 120 kişi dahil edildi. Tüm gruplardaki hastalardan hemogram, biyokimyasal tetkikler, tam idrar tetkiki istendi. Kontrol grubunu sağlıklı hastalardan oluşması sebebi ile tümör markırı, eksik koagülasyon tetkikleri gibi özellikli tetkiklerin eksik olanları istenmedi. Bulgular: Çalışmaya dahil edilen hasta ve kontrol grubu arasında yaş ek hastalık gibi demografik veriler arasından fark saptanmadı. İdrarda nitrit varlığı açısından iki grup arasında anlamlı farklar bulunmuştur (p<0.001). Kontrol grubunda nitrit negatif olanların oranı %100 iken hasta grubunda bu oran %60,0'dır. Nitrit pozitifliği hasta grubunda %40,0 oranında bulunmuştur Sonuç: idrar yolu enfeksiyonu dışlanan tıkanma ikteri tanılı hastalarda idrar nitrit pozitifliğinin anlamlı olarak yüksek saptandığı görülmüştür. İdrar nitriti pozitifliği ile idrar bilirubin düzeyi, serum total ve direkt bilirubin düzeyleri arasında pozitif korelasyon olduğu görülmüştür. Çalışmamız tıkanma ikteri hastalarında idrar nitritini inceleyen literatürdeki ilk çalışma özelliğini taşımaktadır. Tıkanma ikteri gibi mortalite ve morbiditesi yüksek olan bir hastalıkta erken tanı büyük önem arz etmekte olup tam otomatik idrar gibi pratik, maliyeti düşük, hızlı bir yöntemle tanının desteklenmesi ve tedavinin daha erken ve etkin yapılmasında olumlu katkılar oluşturacaktır.
Aim: Obstructive jaundice is a condition characterized by jaundice of the skin, sclera, and mucous membranes resulting from partial or complete obstruction of bile flow due to diseases at any level of the biliary tract (1). This condition can present with various clinical manifestations, ranging from a simple infection that responds to fluid support and antibiotic treatment to a severe infection that can result in organ failure. If not detected early and treated appropriately, it can lead to high mortality rates (2). Normally, nitrite is negative in urine. The most common cause of nitrite positivity in urine is a urinary system infection with bacterial pathogens containing the enzyme nitrate reductase. In our study, we aimed to compare the urinary nitrite excretion in patients diagnosed with obstructive jaundice without urinary infection findings to a control group. Methods: Our study included a total of 120 individuals: 60 patients aged 18-65 with obstructive jaundice followed up at the Gastroenterology Department of Selçuk University Faculty of Medicine Hospital, and 60 individuals in the control group. Complete blood counts, biochemical tests, and complete urinalysis were requested from all patients. Since the control group consisted of healthy individuals, specific tests such as tumor markers and incomplete coagulation tests were not requested. Results: No differences were found in demographic data such as age and comorbidities between the patient and control groups included in the study. Significant differences were found between the two groups regarding the presence of nitrite in the urine (p<0.001). While the rate of nitrite negativity in the control group was 100%, this rate was 60.0% in the patient group. Nitrite positivity was found to be 40.0% in the patient group. Conclusion: It was found that urine nitrite positivity is significantly higher in patients diagnosed with obstructive jaundice, excluding those with urinary tract infections. A positive correlation was observed between urine nitrite positivity and urine bilirubin level, as well as serum total and direct bilirubin levels. Our study is the first in the literature to investigate urine nitrite in patients with obstructive jaundice. Early diagnosis in diseases with high mortality and morbidity, such as obstructive jaundice, is of great importance. Supporting the diagnosis with practical, low-cost, and rapid methods like fully automated urinalysis will contribute positively to earlier and more effective treatment.
Aim: Obstructive jaundice is a condition characterized by jaundice of the skin, sclera, and mucous membranes resulting from partial or complete obstruction of bile flow due to diseases at any level of the biliary tract (1). This condition can present with various clinical manifestations, ranging from a simple infection that responds to fluid support and antibiotic treatment to a severe infection that can result in organ failure. If not detected early and treated appropriately, it can lead to high mortality rates (2). Normally, nitrite is negative in urine. The most common cause of nitrite positivity in urine is a urinary system infection with bacterial pathogens containing the enzyme nitrate reductase. In our study, we aimed to compare the urinary nitrite excretion in patients diagnosed with obstructive jaundice without urinary infection findings to a control group. Methods: Our study included a total of 120 individuals: 60 patients aged 18-65 with obstructive jaundice followed up at the Gastroenterology Department of Selçuk University Faculty of Medicine Hospital, and 60 individuals in the control group. Complete blood counts, biochemical tests, and complete urinalysis were requested from all patients. Since the control group consisted of healthy individuals, specific tests such as tumor markers and incomplete coagulation tests were not requested. Results: No differences were found in demographic data such as age and comorbidities between the patient and control groups included in the study. Significant differences were found between the two groups regarding the presence of nitrite in the urine (p<0.001). While the rate of nitrite negativity in the control group was 100%, this rate was 60.0% in the patient group. Nitrite positivity was found to be 40.0% in the patient group. Conclusion: It was found that urine nitrite positivity is significantly higher in patients diagnosed with obstructive jaundice, excluding those with urinary tract infections. A positive correlation was observed between urine nitrite positivity and urine bilirubin level, as well as serum total and direct bilirubin levels. Our study is the first in the literature to investigate urine nitrite in patients with obstructive jaundice. Early diagnosis in diseases with high mortality and morbidity, such as obstructive jaundice, is of great importance. Supporting the diagnosis with practical, low-cost, and rapid methods like fully automated urinalysis will contribute positively to earlier and more effective treatment.
Açıklama
Anahtar Kelimeler
İdrar Nitriti, Kolestaz, Tıkanma İkteri, Obstructive Jaundice, Urine Nitrite, Cholestasis
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Alan, E. (2024). Tıkanma ikterinde idrarda nitrit pozitifliği. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
