Onkoloji servis ve polikliniğinde takip edilen hastalarda, tanı öncesi ve/veya sırasındaki bazal ürik asit ve hemogram parametrelerinin ölüm ve sağkalım üzerine etkisi
Yükleniyor...
Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Ürik Asit (ÜA) bir çok hastalıkta risk faktörü olarak suçlanmış; yüksekliği gut, hipertansiyon ve kardiyovasküler hastalıklar için risk faktörü olarak değerlendirilmiştir. Bunun yanında Parkinson Hastalığı, Multipl Skleroz ve Alzheimer Hastalığı olanlarda yüksek ÜA seviyesinin protektif olduğu gösterilmiştir. Fakat özellikle malign hastalıklara yol açma veya hastalıkları önleme açısından yapılan çalışmalarda çelişkili sonuçlar ortaya çıkmıştır.
Yöntem: Ocak 2014 tarihinden Ağustos 2015 tarihine kadar Ege Üniversitesi Tıp Fakültesi Hastanesi Onkoloji Bilim Dalına poliklinik ve/veya servise başvuran hastaların tanı sırasında ve/veya en geç 1 ay içerisindeki ÜA sonuçları ile ölüm ve sağ kalım arasında bir ilişki olup olmadığı ve prognoz tayini açısından değerinin olup olmadığı araştırılmıştır.
Bulgular: 997 hastanın 428’inin (%43) ÜA değerlerine ulaşıldı. Ortalama ÜA değerleri tüm hastalar için 4,79 (± 1,82) mg/dl, yaşayan hastaların (260 kişi, %65) 4,57 (± 1,53) mg/dl, ölen hastaların ise (140 kişi, %35) 5,20 (± 2,22) idi (p=0,0006). Erkekler için ÜA referans aralığı 3,5-7,2 mg/dl, kadınlar için 2,6-6 mg/dl olarak alındı. 336 hastanın ÜA’i normal, 62’sinin yüksek ve 30’unun düşük olduğu görüldü. ÜA değerlerini düşük, normal ve yüksek olarak değerlendirdiğimizde 148(428) hastada ortalama sağkalım süresi düşük grupda 18,201 ± 1,426 ay (95% CI 15,407-20,995), normal grupta 70,962 ± 10,244 ay (%95 CI 50,884-91,041) ve yüksek grupda 20,571 ± 2,779 ay (95% CI 15,125-26,017) olarak bulundu. Her 3 grubu karşılaştırdığımızda düşük grupla normal grup arasındaki yaşam süreleri anlamlı (p=0,030), yüksek grupla normal grup arasındaki yaşam süreleri de anlamlı (p=<0,001) olarak bulundu. Düşük grupla yüksek grup karşılaştırıldığında sağkalım açısından bir anlam olmadığı saptandı (p=0,304). Sonuç: ÜA’in hem pro-oksidan hem de anti-oksidan özelliklerinin olduğu; normal değerlerde anti-oksidan, düşük veya yüksek değerlerde ise Pro-oksidan olarak davrandığını görünmektedir.
Object: Uric acid (UA) has been accused of being a risk factor in many diseases and the increase of its level has been evaluated as a risk factor for gout, hypertension and cardiovascular diseases. Besides this, the high level of UA in people having Parkinson’s disease, Multiple Sclerosis and Alzeheimer has been shown as being protective. However, there have been contradictory results especially in the studies made in terms of causing or preventing malign diseases. Method: It has been researched whether there is a relation between “the UA results during the diagnosis and/or in one month at the latest of the patients who applied to the polyclinic and/or service of Ege University Medical Faculty Hospital, Department of Oncology from January 2014 till August 2015” and “death and survival” and whether it has value in terms of determination of prognosis. Findings: 428 (%43) patient’s UA values of 997 patients have been reached. Average UA values for all of the patients was 4,79 (± 1,82) mg/dl, for survivors (260 people, %65) 4,57 (± 1,53), for death patients (140 people, %35) 5,20 (± 2,22) (p=0,0006). UA referance rage was taken as 3,5-7,2 mg/dl for men, as 2,6-6 mg/dl for women. It was realized that UA levels of 336 patients were normal, of 62 were high and of 30 were low. When we categorized UA levels into low, normal and high, average survival period of 148 (428) patients was 18,201 ± 1,426 months (95% CI 15,407-20,995) in the low group, 70,962 ± 10,244 months (%95 CI 50,884-91,041) in the normal group and 20,571 ± 2,779 months (95% CI 15,125-26,017) in the high group. When we compared all 3 groups with each other, the lifetime between low and normal groups was found significant (p:=0,030), the lifetime between high and normal groups was also found significant (p=<0,001). When low group was compared to high group, it was determined that there was no significance with regard to survival (p=0,304). Result: It seems that UA has both pro-oxidant and anti-oxidant features. It behaves as anti-oxidant in normal levels or as pro-oxidant in high levels.
Object: Uric acid (UA) has been accused of being a risk factor in many diseases and the increase of its level has been evaluated as a risk factor for gout, hypertension and cardiovascular diseases. Besides this, the high level of UA in people having Parkinson’s disease, Multiple Sclerosis and Alzeheimer has been shown as being protective. However, there have been contradictory results especially in the studies made in terms of causing or preventing malign diseases. Method: It has been researched whether there is a relation between “the UA results during the diagnosis and/or in one month at the latest of the patients who applied to the polyclinic and/or service of Ege University Medical Faculty Hospital, Department of Oncology from January 2014 till August 2015” and “death and survival” and whether it has value in terms of determination of prognosis. Findings: 428 (%43) patient’s UA values of 997 patients have been reached. Average UA values for all of the patients was 4,79 (± 1,82) mg/dl, for survivors (260 people, %65) 4,57 (± 1,53), for death patients (140 people, %35) 5,20 (± 2,22) (p=0,0006). UA referance rage was taken as 3,5-7,2 mg/dl for men, as 2,6-6 mg/dl for women. It was realized that UA levels of 336 patients were normal, of 62 were high and of 30 were low. When we categorized UA levels into low, normal and high, average survival period of 148 (428) patients was 18,201 ± 1,426 months (95% CI 15,407-20,995) in the low group, 70,962 ± 10,244 months (%95 CI 50,884-91,041) in the normal group and 20,571 ± 2,779 months (95% CI 15,125-26,017) in the high group. When we compared all 3 groups with each other, the lifetime between low and normal groups was found significant (p:=0,030), the lifetime between high and normal groups was also found significant (p=<0,001). When low group was compared to high group, it was determined that there was no significance with regard to survival (p=0,304). Result: It seems that UA has both pro-oxidant and anti-oxidant features. It behaves as anti-oxidant in normal levels or as pro-oxidant in high levels.
Açıklama
Anahtar Kelimeler
Ürik Asit, Kanser, Mortalite, Uric Acid, Cancer, Mortality
