Öz
Amaç
Ektopik gebelik patogenezinde enflamatuar süreçlerin önemli bir etkisi bulunmaktadır. Bu nedenle, bazı serum enflamasyon belirteçlerinin tedavi sürecinin öngörüsünde etkin olabileceği düşünülmektedir. Amacımız, ektopik gebelik tedavisinde kullanılan metotreksatın etkinliği ile serum enflamasyon belirteçlerinin ilişkisini araştırmaktır.
Yöntem
Çalışma, Dokuz Eylül Üniversitesi Hastanesi’ nde retrospektif olarak gerçekleştirilmiştir. 2015-2025 yılları arasında, ektopik gebelik tanısı alarak tedavi edilen 18 yaş ve üzeri kadın olgular çalışmaya dahil edilmiştir. Olgular, öncelikle metotreksat tedavisinin başarılı olup olmamasına göre iki gruba ayrılmıştır. Metotreksat tedavisi başarılı olan olgular kendi içerisinde tek doz ve çift doz tedavi uygulanan olgular olarak ayrıca iki gruba ayrılmıştır. Gruplar, karakteristik özellikleri, ultrason, laboratuvar ve cerrahi bulguları açısından karşılaştırılmıştır.
Bulgular
Çalışmamızın sonucunda, metotreksat tedavisinin başarılı olduğu grupla başarısız olduğu grup arasında, sistemik enflamasyon belirteçleri açısından anlamlı fark saptanmamıştır (p=0,96, p=0,58, p=0,47, p=0,80). Metotreksat tedavisinin başarılı ve başarısız olduğu gruplar, başlangıç, 4. ve 7. gün β HCG düzeyleri ve aralarındaki değişim açısından karşılaştırıldığında anlamlı fark saptanmıştır (p<0,001). β HCG'’ nin tedavi başarısını öngörmede etkin bir belirteç olduğu saptanmıştır (p=0,001, p=0,001, p=0,006).
Sonuç
Sonuç olarak, serum enflamasyon belirteçleriyle metotreksat tedavisinin başarısı arasında anlamlı bir ilişki saptanmamıştır. β HCG düzeyi ve β HCG değişim oranlarının metotreksat tedavisinin başarısını öngörmede daha güçlü bir belirteç olduğu düşünülmektedir.
Anahtar Kelimeler: Ektopik gebelik, serum enflamasyon belirteçleri, metotreksat
Kaynakça
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