{"id":14849,"date":"2021-01-05T01:23:01","date_gmt":"2021-01-04T22:23:01","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/\/2021\/01\/05\/karaciger-biyopsisi-yapilmis-olan-hbeag-negatif-kronik-hepatit-b-hastalarinin-rehberler-esliginde-degerlendirilmesi\/"},"modified":"2021-01-05T01:23:01","modified_gmt":"2021-01-04T22:23:01","slug":"karaciger-biyopsisi-yapilmis-olan-hbeag-negatif-kronik-hepatit-b-hastalarinin-rehberler-esliginde-degerlendirilmesi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2021\/01\/05\/karaciger-biyopsisi-yapilmis-olan-hbeag-negatif-kronik-hepatit-b-hastalarinin-rehberler-esliginde-degerlendirilmesi\/","title":{"rendered":"Karaci\u011fer Biyopsisi Yap\u0131lm\u0131\u015f Olan HBeAg-Negatif Kronik Hepatit B Hastalar\u0131n\u0131n Rehberler E\u015fli\u011finde De\u011ferlendirilmesi"},"content":{"rendered":"<h1>\u00d6zet<\/h1>\n<p> <strong>Ama\u00e7: <\/strong>\u00dclkemizde hepatit B hastalar\u0131n\u0131n \u00e7o\u011funlu\u011funu olu\u015fturan HBeAg-negatif hastalarda tedavi karar\u0131 ancak karaci\u011fer biyopsisi uygulanarak verilebilmektedir. Rehberlere g\u00f6re baz\u0131 hasta gruplar\u0131nda HBV DNA ve alanin aminotransferaz (ALT) d\u00fczeyiyle tedavi karar\u0131 verilmesi \u00f6nerilmekte, karaci\u011fer biyopsisi yapma zorunlulu\u011fu bulunmamaktad\u0131r. Karaci\u011ferin fibroz durumunu de\u011ferlendirmek i\u00e7in invazif olmayan fibroz \u00f6l\u00e7\u00fcm testleri de kullan\u0131labilmektedir. \u00c7al\u0131\u015fmam\u0131zda, fibroz \u00f6l\u00e7\u00fcm testlerinin invazif bir i\u015flem olan karaci\u011fer biyopsisi sonucunu \u00f6ng\u00f6rebilirli\u011finin ara\u015ft\u0131r\u0131lmas\u0131, hastalar\u0131m\u0131z\u0131n rehberler ve \u00fclkemizde uygulanan tedavi kriterleri a\u00e7\u0131s\u0131ndan de\u011ferlendirmesi ama\u00e7lanm\u0131\u015ft\u0131r.<\/p>\n<p> <strong>Y\u00f6ntemler:<\/strong> Klini\u011fimizde karaci\u011fer biyopsisi yap\u0131lm\u0131\u015f olan 25 hasta retrospektif olarak incelendi. Hastalar\u0131n demografik \u00f6zellikleri, karaci\u011fer biyopsisi patoloji sonu\u00e7lar\u0131, HBV DNA d\u00fczeyleri, tedavi ba\u015flanma durumlar\u0131 kay\u0131t alt\u0131na al\u0131nd\u0131. \u201cAST to Platelet Ratio Index\u201d (APRI) ve \u201cFibrosis-4\u201d\u00a0 (FIB4) skorlar\u0131 hesapland\u0131. APRI ve FIB4 sonu\u00e7lar\u0131yla karaci\u011fer biyopsisi sonu\u00e7lar\u0131n\u0131n korelasyonu ara\u015ft\u0131r\u0131ld\u0131. Tedavi ba\u015flanamayan hastalar\u0131n rehberlere g\u00f6re tedaviye uygunluk durumu de\u011ferlendirildi.<\/p>\n<p> <strong>Bulgular: <\/strong>Biyopsi sonu\u00e7lar\u0131yla Sa\u011fl\u0131k Uygulama Tebli\u011fi\u2019ne g\u00f6re 15 hastaya tedavi ba\u015flan\u0131rken, hastalar\u0131n 10 (%40)\u2019una tedavi ba\u015flanamad\u0131. Bu hastalar\u0131n 6\u2019s\u0131 HBV DNA ve ALT d\u00fczeyi y\u00fcksek olan hastalard\u0131. Hastalar\u0131n APRI skoruyla, karaci\u011fer biyopsisindeki Ishak histolojik aktivite indeksi ve fibroz skoru aras\u0131nda korelasyon saptanmad\u0131 (p=0.4, p=0.3). FIB4 skoru, biyopsi sonucundaki Ishak histolojik aktivite indeksi (p=0.03) ile korele iken, fibroz skoru (p=0.5) ile korele de\u011fildi.<\/p>\n<p> <strong>S<\/strong><strong>onu\u00e7lar<\/strong>: \u00c7al\u0131\u015fmam\u0131zda biyopsi yap\u0131lan hastalar\u0131n %40\u2019\u0131na tedavi ba\u015flanamad\u0131\u011f\u0131, bu hastalar\u0131n bir k\u0131sm\u0131n\u0131n rehberlere g\u00f6re karaci\u011fer biyopsisi uygulanma zorunlulu\u011fu olmadan tedavi \u00f6nerilen hastalar oldu\u011fu anla\u015f\u0131lm\u0131\u015ft\u0131r. Fibroz testleri biyopsi yap\u0131lmadan karaci\u011fer biyopsisi sonucunu \u00f6ng\u00f6rebilme konusunda yetersiz kalmaktad\u0131r. Karaci\u011fer biyopsisi uygulanma gereksinimini azaltma konusunda yard\u0131mc\u0131 olamayacaklar\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir.<\/p>\n<p> <strong>Cite this article as:<\/strong> Solak-Grassie S, G\u00f6z\u00fctok F, Co\u015fkun B, Dural S, Atakent \u015eD. [Evaluation of HBeAg-negative chronic hepatitis B patients who had undergone liver biopsy in accordance with the guidelines]. Klimik Derg. 2018; 31(1): 37-40. Turkish.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00d6zet Ama\u00e7: \u00dclkemizde hepatit B hastalar\u0131n\u0131n \u00e7o\u011funlu\u011funu olu\u015fturan HBeAg-negatif hastalarda tedavi karar\u0131 ancak karaci\u011fer biyopsisi uygulanarak verilebilmektedir. Rehberlere g\u00f6re baz\u0131 hasta gruplar\u0131nda HBV DNA ve alanin aminotransferaz (ALT) d\u00fczeyiyle tedavi karar\u0131 verilmesi \u00f6nerilmekte, karaci\u011fer biyopsisi yapma zorunlulu\u011fu bulunmamaktad\u0131r. Karaci\u011ferin fibroz durumunu de\u011ferlendirmek i\u00e7in invazif olmayan fibroz \u00f6l\u00e7\u00fcm testleri de kullan\u0131labilmektedir. \u00c7al\u0131\u015fmam\u0131zda, fibroz \u00f6l\u00e7\u00fcm testlerinin invazif [&hellip;]<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[4670,4672,3525],"class_list":["post-14849","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-biyopsi","tag-fibroz","tag-hepatit-b"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/14849","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=14849"}],"version-history":[{"count":0,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/14849\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=14849"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=14849"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=14849"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}