Bu çalışmanın en önemli sonucu, periferik kanda eozinofili saptanan KOAH’lı hastalarda alevlenme riski ve bunun yanında hastane yatışı gerektiren şiddetli alevlenme riskinin yüksek saptanmış olmasıdır. Literatürde yer alan çalışma verileri doğrultusunda yaptığımız analizlerde, KOAH’lı hastalarda periferik kanda eozinofilinin, semptom skorları, solunum fonksiyon testi, GOLD grupları açısından yapılan karşılaştırmasında anlamlı farklılık bulunmamıştır. Bunun yanısıra sistemik inflamasyon belirteçleri olarak bilinen CRP, fibrinojen ve NLR düzeyleri de karşılıştırılmış ancak anlamlı bir farklılık görülememiştir.
KOAH, farklı fenotipik özellikleri olması ve her hastanın bireysel olarak değerlendirilip tedavisinin düzenlenmesi gerektiği bir hastalıktır. Bu nedenle eozinofilik olan hastaların daha yakın izlemi ve alevlenme önleyici yaklaşımlar açısından daha dikkatli değerlendirilmeleri gerekmektedir.
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76 OLGU RAPOR FORMU
KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI(KOAH) OLAN EOZİNOFİLİK VE NON-EOZİNOFİLİK OLGULARIN KLİNİK GİDİŞ, ALEVLENMELER, YAŞAM KALİTESİ VE TEDAVİYE YANIT AÇISINDAN KARŞILAŞTIRILMASI: PROSPEKTİF
ÇALIŞMA
OLGU RAPOR FORMU/BAŞLANGIÇ 1 HASTA NO:
Cinsiyet: Yaş: spO2: Komorbidite:
0-HT 6-OSAS 1-Diyabet 7-Akciğer ca
2-KAH 8-Akciğer dışı malignite 3-KKY 9-Anksiyete/depresyon 4-SVO
5-Osteoporoz
Sigara: p-y: kullanım: yok/aktif/pasif / bırakmış biomass: var/yok
Yakıt tipi: 0-kömür süre: 1-kömür+odun 2- tezek 3- hepsi 4-yok 5-tezek+kömür HEMOGRAM: lökosit: Hb: eozinofil: % sayı: lenfosit: PLT: Nötrofil: NLR: PLR:
77
CRP:
KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI(KOAH) OLAN EOZİNOFİLİK VE NON-EOZİNOFİLİK OLGULARIN KLİNİK GİDİŞ, ALEVLENMELER, YAŞAM KALİTESİ VE TEDAVİYE YANIT AÇISINDAN KARŞILAŞTIRILMASI: PROSPEKTİF
ÇALIŞMA
OLGU RAPOR FORMU/BAŞLANGIÇ 2 Fibrinojen: Prokalsitonin: CAT: MMRC: Balgam eozinofili: SFT: FEV1:% ml postFEV1:% ml FVC:% ml postFVC: % ml FEV1/FVC:% postFEV1/FVC:% Reverzibilite: var/yok DLCO: DLCO_VA: Alevlenme öyküsü:Alevlenme sayısı(önceki yıl): 0-Acil 1-Ayaktan plk 2-Hastane yatışı İlaç: İlaç içerik: İlaç: orijinal/muadil GOLD grubu: Akciğer grafisİ: Eski FEV1 değerleri:
78
KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI(KOAH) OLAN EOZİNOFİLİK VE NON-EOZİNOFİLİK OLGULARIN KLİNİK GİDİŞ, ALEVLENMELER, YAŞAM KALİTESİ VE TEDAVİYE YANIT AÇISINDAN KARŞILAŞTIRILMASI: PROSPEKTİF
ÇALIŞMA
OLGU RAPOR FORMU/KONTROL HASTA NO:
spO2: HEMOGRAM: lökosit: Hb: eozinofil: % sayı: lenfosit: PLT: Nötrofil: NLR: PLR: CRP: Fibrinojen: CAT: MMRC: SFT: FEV1:% ml postFEV1:% ml FVC:% ml postFVC: % ml FEV1/FVC:% postFEV1/FVC:% Reverzibilite: var/yok