Akut viral hepatit'te N-asetilsistein tedavisi
Küçük Resim Yok
Tarih
2003
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Dergi ISSN
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Akut viral hepatit (AVH) sık, uzun seyirli ve seyrek olmayarak ciddi sorunlara yol açabilen önemli bir hastalıktır. Ülkemizin de aralarında bulunduğu gelişmekte olan ülkeler için bir toplum sağlığı sorunu niteliğindedir AVH olgularında hastalık süresini kısaltabilen bir tedaviye gereksinim açık iken bu alandaki boşluk henüz doldurulabilmiş değildir. Çalışmamızın amacı hücre içi glutatyon miktarını arttırarak potansiyel toksik ajanlar olan serbest oksijen radikalleri ile reaksiyona girip hücresel bütünlüğü koruyabilen N-asetilsistein (NAS)in AVH tedavisindeki etkisini araştırmaktır. Gereç ve Yöntem: Bu amaçla AVH tanısıyla yatırılarak izlenen hastalari iki gruba ayırıp çalışma grubunda günde üç kez 200 mg (600 mg/gün), oral NAS; kontrol grubunda ise plasebo kapsüller uyguladık. Hastaların çalışmaya dahil edilmelerinden itibaren serum total ve direkt bilirubin, ALT, AST, alkali fosfataz, albümin ve globulin seviyeleri, protrombin aktiviteleri haftada iki kere ölçüldü. Bu izlem serum total bilirubin seviyesinin 2 mg/dl'ye, ALT düzeyinin 100 U/L'nin altına inmesine kadar sürdürülerek hastalar taburcu edildi. Bulgular: İ.Ü Cerrahpaşa Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Enfeksiyon Hastalıkları Bilim Dalı'na AVH tanısıyla yatırılan 41 olgu çalışmaya alındı. Olguların 13 (%31.7)'ü kadın, 28 (%68.3)'i erkekti. Tüm olgularda ortanca yaş 24 (sınırlar:15-52) olup A tipinde ortanca yaş 17 (sınırlar:16-28), B tipinde ise ortanca yaş 26 (sınırlar:15-52) bulundu. Çalışma grubunda ortanca yaş 23 (sınırlar:15-48) kontrol grubunda ise ortanca yaş 24 (sınırlar:16-52) bulundu. HAV ile enfekte hastaların yaşı belirgin olarak küçüktü. Olguların serolojik ayırımında A tipi 9 (%22), B tipi 32 (%78) olguda bulundu. Çalışma grubunda A tipi 4 (%20), B tipi 16 (%80), kontrol grubunda ise A tipi 5 (%23.7), B tipi 16 (%76.4) idi. ALT nin normale dönüş süresi çalışma grubunda 19.7±6.9 gün (A tipi 11.2±6.1 gün, B tipinde 21.8±6.1gün), kontrol grubunda ise 20.4±6.5 gün (A tipi 16±7.4 gün, B tipi 21.8 ±6.7 gün) bulundu. Total bilirubin'in normale dönüş süresi çalışma grubunda 13.7±8.5 gün (A tipi 7.9± 4.9 gün, B tipi 15.2±8.6 gün), kontrol grubunda ise 16.9±7.8 gün (A tipi 12±6.3 gün, B tipi 18.4 ± 8.1 gün) olarak bulundu. Sonuç: NAS kullandığımız hastaların ALT ve total bilirubin değerlerinin normale dönme süresi dolayısıyla hastanede yatış süresi kısalmamış veya olumsuz yönde etkilenip uzamamıştır. Bu bulguların ikterli AVH'in tedavisi için NAS'in önerilemeyeceği sonucu çıkartılabilmektedir. Ayrıca bu ilacın AVH olgularında zararlı olmadığı da anlaşılmıştır.
Objective: Acute viral hepatitis (AVH) that may cause serious problems, is a frequent disease with along course. It is a public health problem among developing countries such as our country. The need for a treatment to shorten duration of AVH is obvious, but it has not been solved yet. We thought this problem may be solved with NAS which protects the cellular architecture by increasing the amount of intracellular glutathion that reacts with toxic free oxygen radicals. Material and Method: For this purpose, we administered 200 mg orally NAS three times daily (600 mg/day) to the study group and placebo capsules to those in the control group, who are hospitalized and followed with the diagnosed of AVH. This patient's blood total and direct bilirubin, ALT, AST, alkalen phosphotase, albumin and globulin levels are measured twice weekly. This follow up is continued until total bilirubin level becomes 2mg/dl, ALT level becomes 100 U/L and then the patients are discharged from hospital. Results: 41 cases of AVH patients included our study in I.U Cerrahpaşa Medical Faculty, The Department of Internal Medicine, Infectious Disease Unit. 13 patients (%31.7) were female, 28 patients (%68.3) were male. The median age among was 24 (range:15-52), in A type the median age was 17 (range:16-28), in B type it was 26 (range:15-52). In the study group median age was 23 (range:15-48), in the control group it was 24 (range:16-52). Patients with HAV infection were younger than those with HBV infection. In the serological distinction of the cases, A type was detected in 9 (%22) and B type in 32 (%78), in study group A type was in 4 (%20), B type was in 16 (%80), in control group A type was in 5 (%23.7) and B in 16 (76.4). The period for normalization of ALT in study group was 19.7±6.9 days (A type 11.2±6.1 days, B type 21.8±6.1 days), while in the control group it was 20.4±6.5 days (A type 16±7.4 days, B type 21.8±6.7 days). The period for normalization of total bilirubin in study group was 13.7±8.5 days (A type 7.9±4.9 days, B type 15.2±8.6 days), in control group was 16.9±7.8 days (A type 7.9±4.9 days, B type 18.4±8.1 days). Conclusion: As a result, NAS administeration effected neither the time necessary for normalization of ALT and total bilirubin values nor duration of hospitalization, so we could not suggest the of NAS for the treatment of icteric AVH cases. However our results showed that to this drug was not harmful to the patients with AVH.
Objective: Acute viral hepatitis (AVH) that may cause serious problems, is a frequent disease with along course. It is a public health problem among developing countries such as our country. The need for a treatment to shorten duration of AVH is obvious, but it has not been solved yet. We thought this problem may be solved with NAS which protects the cellular architecture by increasing the amount of intracellular glutathion that reacts with toxic free oxygen radicals. Material and Method: For this purpose, we administered 200 mg orally NAS three times daily (600 mg/day) to the study group and placebo capsules to those in the control group, who are hospitalized and followed with the diagnosed of AVH. This patient's blood total and direct bilirubin, ALT, AST, alkalen phosphotase, albumin and globulin levels are measured twice weekly. This follow up is continued until total bilirubin level becomes 2mg/dl, ALT level becomes 100 U/L and then the patients are discharged from hospital. Results: 41 cases of AVH patients included our study in I.U Cerrahpaşa Medical Faculty, The Department of Internal Medicine, Infectious Disease Unit. 13 patients (%31.7) were female, 28 patients (%68.3) were male. The median age among was 24 (range:15-52), in A type the median age was 17 (range:16-28), in B type it was 26 (range:15-52). In the study group median age was 23 (range:15-48), in the control group it was 24 (range:16-52). Patients with HAV infection were younger than those with HBV infection. In the serological distinction of the cases, A type was detected in 9 (%22) and B type in 32 (%78), in study group A type was in 4 (%20), B type was in 16 (%80), in control group A type was in 5 (%23.7) and B in 16 (76.4). The period for normalization of ALT in study group was 19.7±6.9 days (A type 11.2±6.1 days, B type 21.8±6.1 days), while in the control group it was 20.4±6.5 days (A type 16±7.4 days, B type 21.8±6.7 days). The period for normalization of total bilirubin in study group was 13.7±8.5 days (A type 7.9±4.9 days, B type 15.2±8.6 days), in control group was 16.9±7.8 days (A type 7.9±4.9 days, B type 18.4±8.1 days). Conclusion: As a result, NAS administeration effected neither the time necessary for normalization of ALT and total bilirubin values nor duration of hospitalization, so we could not suggest the of NAS for the treatment of icteric AVH cases. However our results showed that to this drug was not harmful to the patients with AVH.
Açıklama
Anahtar Kelimeler
Akut Viral Hepatit (AVH), N-asetilsistein (NAS)
Kaynak
Medical Network Klinik Bilimler ve Doktor
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
2
