Kardiyopulmoner bypass uygulanan köpeklerde pentoksifilin ve aprotininin serebral koruyucu etkilerinin araştırılması
Küçük Resim Yok
Tarih
2002
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kardiyopulmoner bypass esnasında kanın yabancı yüzeylerle temas etmesi neticesinde, enflamatuar cevap oluşur. Bu tip patolojik durumlarda, beyinde etkilenebilir ve nörolojik komplikasyonlar oluşabilir. Kalp - akciğer pompasının, neden olduğu, santral sinir sistemindeki disfonksiyonu azaltmada, petoksifilin ve aprotininin serebroprotektif etkileri araştırıldı. Metod : Prospektif deneysel çalışmada, grup I ( n = 6, kontrol ), grup II ( n = 6, pentoksifılin ) ve grup III ( n = 6, aprotinin ) ' deki toplam 18 sağlıklı köpekte, kardiyopulmoner bypass uygulandı. II. gruba, preoperatif 3 gün süresince ve peroperatif 300 mg/ gün pentoksifilin; III. gruba, aprotinin 1 milyon IU prime solüsyona, 500 bin IU santral venden infüze edilldi. Kardiyopulmoner bypass başlamadan önce ve sonra internal juguler venden kan örnekleri ve postoperatif serebral koıteks biopsileri alındı. Biyokimyasal olarak IL-6, TNF- a, GSH- PX ve S 100 protein markırlarma bakıldı. Histopatolojik olarak ışık mikroskobunda beyin dokusunda gliozis araştırıldı. Bulgular : Postoperatif biyokimyasal markır seviyelerinden TNF- a, S 100 protein ve EL-6, preoperatif değerlerle kıyaslandığında, farklılık anlamlı bulundu ( p < 0.0001 ). Bu anlamlı farklılık, her 3 değer için, grup I. ,11. , III. ; grup I ile grup II ve grup I ile grup III arasında da vardı ( p < 0.0001). Grup II ile grup III arasında anlamlılık tespit edilmedi, pentoksifilin ve aprotinin için, markırlar kendi grupları aralarında preoperatif ve postoperatif karşılaştırıldığında, EL- 6, TNF- a ve GSH-PX arasındaki farklılık anlamlı ( p < 0.0001 ), S 100 için anlamlı bulunmadı. Histopatolojik olarak, kontrol grubu ile pentoksifilin ve aprotinin grubları arasında ve aprotinin ile pentoksifilin grupları arasında farklılık anlamlı bulundu ( p < 0.001 ) . 28 Sonuçlar : CPB ile kardiyak cerrahi uygulanan hastalarda, pentoksifilin ve aprotinin postoperatif enflamasyonu ve gliozis oluşumunu azaltmaktadır
Objective : Systemic enflammation occurs when the blood contact with foreign surface during cardiopulmonary bypass. In these pathological circumtances the cerebrum can also be affected to neurological complications. In this expremental study cerebroprotective roles of pentoxyfilline and aprotinin are searhced in reducing the central nervous system dysfonction.Method : Eighteen healty dogs were divided into three groups; group I ( control, n = 6 ), group II ( pentoxyfilline, n = 6 ),and group III ( aprotinin, n = 6 ). Standart cardiopulmonary bypass was performed to all subject. Preoperatively 3 days and peroperatively 300 mg. Pentoxyfilline was administered in group II, wheras 1 million IU aprotinin was administered to prime solution and 500.000 IU transfusion via central jugular catather preoperatively in group III. Before and after the cardiopulmonary bypass blood samples were taken from the central jugular vein and serebral cortex examination biopsies postoperatively. In biochemical IL-6, TNF-ct, GSH-PX, and S 100 protein were studied. In histopathological examination gliozis was observed under light microscope.Results : Comparing the postoperative and preoperative results of IL-6, TNF-a, and S100 protein were found to be statistically significant ( p < 0.001 ). This significant difference was observed in the same parameters between groups I and II, I and III ( p < 0.001 ). There was no significant difference between groups II and III. Comparing the preoperative and postoperative biochemicals results in groups II and III , IL-6 differences ( p < 0.001 ). Whereas S 100 showed no significant difference histopathologically comparisons of group I with group II and III, and group III with II were found to be statistically significant ( p < 0.001 )30Conclusions : The administrations of pentoxyfilline and aprotinin reduce the postoperative inflammations and gliozis formations when the cardiopulmonary bypass is used in cardiac surgery performed patients.
Objective : Systemic enflammation occurs when the blood contact with foreign surface during cardiopulmonary bypass. In these pathological circumtances the cerebrum can also be affected to neurological complications. In this expremental study cerebroprotective roles of pentoxyfilline and aprotinin are searhced in reducing the central nervous system dysfonction.Method : Eighteen healty dogs were divided into three groups; group I ( control, n = 6 ), group II ( pentoxyfilline, n = 6 ),and group III ( aprotinin, n = 6 ). Standart cardiopulmonary bypass was performed to all subject. Preoperatively 3 days and peroperatively 300 mg. Pentoxyfilline was administered in group II, wheras 1 million IU aprotinin was administered to prime solution and 500.000 IU transfusion via central jugular catather preoperatively in group III. Before and after the cardiopulmonary bypass blood samples were taken from the central jugular vein and serebral cortex examination biopsies postoperatively. In biochemical IL-6, TNF-ct, GSH-PX, and S 100 protein were studied. In histopathological examination gliozis was observed under light microscope.Results : Comparing the postoperative and preoperative results of IL-6, TNF-a, and S100 protein were found to be statistically significant ( p < 0.001 ). This significant difference was observed in the same parameters between groups I and II, I and III ( p < 0.001 ). There was no significant difference between groups II and III. Comparing the preoperative and postoperative biochemicals results in groups II and III , IL-6 differences ( p < 0.001 ). Whereas S 100 showed no significant difference histopathologically comparisons of group I with group II and III, and group III with II were found to be statistically significant ( p < 0.001 )30Conclusions : The administrations of pentoxyfilline and aprotinin reduce the postoperative inflammations and gliozis formations when the cardiopulmonary bypass is used in cardiac surgery performed patients.
Açıklama
Anahtar Kelimeler
Kardiyopulmoner bypass, Cardiopulmonary bypass, pentoksifilin, pentoxifylline, aprotini, aprotinin
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Hoşgör, K. (2002). Kardiyopulmoner bypass uygulanan köpeklerde pentoksifilin ve aprotininin serebral koruyucu etkilerinin araştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Göğüs Cerrahisi Anabilim Dalı, Konya.
