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Eritrosit Sedimantasyon Hızı ve C-Reaktif Protein: Hâlâ Değerli mi?

ERYTHROCYTE SEDIMENTATION RATE AND C-REACTIVE PROTEIN: ARE THEY STILL WORTHWHILE?

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Abstract (2. Language): 
Objective: It is important to use simple, cheap, rapid and reliable laboratory tests in primary care. Erythrocyte sedi¬mentation rate (ESR), one of the most frequently used tests, has lost its popularity after the introduction of modern laboratory test in clinical practice. The aim of this study is to determine the sensitivity and specificity of ESR and C—reac-tive protein (CRP). Method: Five hundred patients selected from Adana Numune Hospital Internal Medicine Outpatient Clinic were grouped as healthy, malignancy, rheumatological diseases, infections and other diseases using medical history, physical and laboratory examination. Results: Of 500 patients, 36.6% (n=183) had infectious dis¬eases, 34.2% (n=171) other diseases, 4.2% (n=21) malig¬nancy, 6.2% (n=31) rheumatological diseases and 18.8% (n=94) were healthy. ESR increased by age in both genders. The highest ESR values were in malignant and rheumatolog-ical diseases. High ESR values were found in 100% of malig¬nancy cases, 97% of rheumatological, 65% of infectious, 36% of other diseases and 22% of healthy individuals. Overall sensitivity of ESR was 72.3% and specificity was 77.7%; they were 53.2% and 83% for CRP, respectively. When compared with CRP, the sensitivity of ESR was 81.6% and specificity was 59.6%. Conclusion: ESR for sensitivity and CRP for specificity seemed to be superior. Using two tests together might pro¬vide both high sensitivity and high specificity in diagnosis.
Abstract (Original Language): 
Amaç: Birinci basamakta basit, ucuz, hızlı ve doğru laboratu-var testlerinin kullanımı önemlidir. En sık kullanılan testlerden eritrosit sedimentasyon hızı (ESH), modern laboratuvar yöntemlerinin klinik kullanıma girmesiyle popülaritesini kaybetmiştir. Bu çalışmadaki amacımız, ESH ve C—reaktif proteinin (CRP) tanısal duyarlılığını ve özgüllüğünü saptamaktır. Yöntem: Adana Numune Eğitim ve Araştırma Hastanesi Dahiliye Polikliniği'nden seçilen 500 olguyu; öykü, fizik muaye¬ne ve laboratuvar tetkiklerine dayanarak sağlıklı, romatizmal hastalıklar, enfeksiyonlar, habis hastalıklar ve diğerleri olmak üzere beş gruba ayırdık. Bulgular: Olguların %36.6'sında (n=183) enfeksiyon hastalıkları, %34.2'sinde (n=171) diğer hastalıklar, %4.2'sinde (n=21) habis hastalıklar, %6.2'sinde (n=31) romatizmal hastalıklar saptandı, %18.8'i (n=94) sağlıklıydı. Her iki cinste de ESH değeri yaşla artmaktaydı. En yüksek ESH değerleri habis ve romatizmal hastalıklardaydı. Sedimantasyon, habis has¬talıkların %100'ünde, romatizmal hastalıkların %97'sinde, enfeksiyon hastalıklarının %65'inde, diğer hastalıkların %36'sında, sağlıklı bireylerin ise %22'sinde yüksekti. ESH'nin duyarlılığı %72.3, özgüllüğü %77.7; CRP'nin du¬yarlılığı %53.2, özgüllüğü %83 idi. CRP'ye göre ise ESH'nın duyarlılığı %81.6, özgüllüğü ise %59.6 idi. Sonuç: Duyarlılık açısından ESH, özgüllük açısından ise CRP daha üstün görünmektedir. Bu iki testin birlikte kullanımı ile tanıda yüksek duyarlılık ve özgüllüğe ulaşılabilir.

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