Orta Karadeniz bölgesindeki çocuklarda Helikobakter Pilori enfeksiyonu sıklığı ve demir eksikliği anemisi ile ilişkisi

Yıl 2019, Cilt: 17 Sayı: 2, 209 - 219, 02.08.2019

Sibel Uçak Semirgin

Öz

GİRİŞ ve AMAÇ: Çalışmanın amacı, Orta Karadeniz bölgesindeki çocuklarda
Helikobakter Pilori (H.Pilori) pozitiflik oranının belirlenmesi; H.Pilori
enfeksiyonunun, demir eksikliği anemisi (DEA) ve ilişkili hematolojik
parametreler ile korelasyonunun değerlendirilmesidir.

YÖNTEM ve GEREÇLER: Çalışmaya gastrointestinal sistem semptomları nedeni ile
C-14 üre nefes testi uygulanan çocuklar dahil edildi. Hemoglobin, hematokrit,
ortalama eritrosit hacmi (n=852); serum demir düzeyi (n=175), demir bağlama
kapasitesi (n=175), ferritin (n=197), transferrin satürasyonu (n=254) ve C-14
üre nefes testi sonuçları (n=1006) retrospektif olarak değerlendirildi.
H.Pilori pozitiflik oranı belirlendi; H.Pilori pozitif ve negatif çocuklarda
hematolojik parametreler karşılaştırıldı. 

BULGULAR: Çalışmaya dahil edilen çocuk hastaların %46,8’ inde H.Pilori pozitif
idi. H.Pilori pozitif hastalarda hemoglobin ve hematokrit düzeylerinin negatif
hastalara kıyasla anlamlı oranda düşük olduğu tespit edildi (hemoglobin için T:
4,014 P: 0,000; hematokrit için T: 3,486 P: 0,001). Ortalama eritrosit hacmi
H.Pilori pozitif hastalarda düşük olmakla birlikte, istatistiksel olarak
anlamlı değildi. Serum demir düzeyi (T: 2,297 P: 0,023), ferritin düzeyi (T:
2,19 P: 0,03) ve transferrin saturasyonu (T: 2,541 P: 0,012) H.Pilori pozitif
hastalarda anlamlı düzeyde düşük saptandı. Demir bağlama kapasitesi açısından
anlamlı fark izlenmedi. Anemik çocuklarda (x²: 23,533 P: 0,000), transferrin
düzeyi düşük olan çocuklarda (x²: 4,948 P: 0,026), ferritin düzeyi düşük olan
çocuklarda (x²: 6,96 P: 0,008) ve ferritin düzeyi düşük olan anemik çocuklarda
(x²: 13,74 P: 0,00) H.Pilori pozitiflik oranının yüksek olduğu tespit edildi.
Kızlarda ve erkeklerde H.Pilori pozitif çocuklarda anemi oranı anlamlı düzeyde
yüksek bulundu (kızlarda x²: 9,033 P: 0,003; erkeklerde x²: 15,016 P:
0,000). 

TARTIŞMA ve SONUÇ: Orta Karadeniz bölgesinde gastrointestinal sistem semptomu
olan çocuklardaki H.Pilori pozitiflik oranının, ülkemizin diğer bölgelerindeki
oranlar ile karşılaştırıldığında ortanca değer düzeylerinde olduğu düşünülmektedir.
Çalışmaya dahil olan geniş pediatrik populasyondan elde edilen sonuçlar,
H.Pilori enfeksiyonu ile DEA arasındaki ilişkiyi desteklemektedir

Anahtar Kelimeler

Helikobakter Pilori, anemi, C-14 üre nefes testi

Pediatric Helicobacter Pylori infection prevalence and iron deficiency anemia coincidence among children in North Central Turkey

Öz

INTRODUCTION: To estimate Helicobacter Pylori (H.Pylori) prevalence,
coincidence of iron deficiency anemia (IDA) and related hematological
parameters in children of North Central Turkey. 

METHODS: Hemoglobin, hematocrit, mean corpuscular volume (n=852); serum iron
level (n=175), iron binding capacity (n=175), ferritin (n=197), transferrin
saturation (n=254) and 14C urea breath test results (n=1006) were reviewed in
children with nonspecific gastrointestinal symptoms. H.Pylori prevalence was
determined; hematological parameters were compared in H.Pylori positive and
negative patients. 

RESULTS: Overall H.Pylori prevalence was 46,8%. Hemoglobin and hematocrit
values were significantly lower in H. Pylori positive patients (T: 4,014 P:
0,000 for hemoglobin; T: 3,486 P: 0,001 for hematocrit). Although MCV values
were lower in H. Pylori positive patients, the difference was not statistically
significant.Serum iron levels (T: 2,297 P: 0,023), ferritin levels (T: 2,19 P:
0,03) and transferrin saturations (T: 2,541 P: 0,012) were significantly lower
in H.Pylori positive patients. Iron binding capacity was higher in H.Pylori
positive patients but this was also not significant. H.Pylori positivity is
significantly higher in anemic patients (x²: 23,533 P: 0,000), in patients with
low transferrin (x²: 4,948 P: 0,026), low ferritin (x²: 6,96 P: 0,008) and in
patients with low ferritin and anemia together (x²: 13,74 P: 0,00). In females
and males, anemia was significantly higher in H.Pylori positive patients (x²:
9,033 P: 0,003 and x²: 15,016 P: 0,000 in females and males respectively).

DISCUSSION AND CONCLUSION: H.Pylori positivity rate in the pediatric population
of North Central Turkey seems to be a median value within the range of yet
reported Turkish prevalence. There is an association between H.Pylori and IDA
according to the results of a large pediatric population

Anahtar Kelimeler

Helicobacter Pylori, anemia, 14C urea breath test.

Kaynakça

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