Akut mezenter iskemi tanısında yeni belirteçler
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2010
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info:eu-repo/semantics/openAccess
Özet
Bu çalışmada; tavşanlarda deneysel AMİ modeli kullanılarak, serum Diamin Oksidaz (DAO), Prokalsitonin, D-Dimer, Amilaz ve Fosfor düzeylerinin AMİ erken tanısındaki önemi ve kullanılabilirliği araştırıldı. Ayrıca; bu dört belirtecin zamana bağlı değişikliklerinin incelenmesi, intestinal iskemi ile ne kadar korele olduğu değerlendirilirken, belirteçlerin birbirine üstünlüğü olup olmadığı ve bu belirteçlerin birlikte kullanımının önemi de araştırıldı.Gereç ve YöntemÇalışmada 21 adet Yeni Zelanda tavşanı kullanıldı. Hayvanlar rastgele olarak yedişer hayvandan oluşan 3 gruba ayrıldı. Bu gruplar: Kontrol, Sham ve İskemi grubu olarak adlandırıldı. Kontrol grubundaki tavşanlarda herhangi bir girişim yapılmadı. Sham ve İskemi grubundaki deneklere orta hat insizyonu ile laparotomi yapıldı. Sham grubuna periton geçildikten sonra başka bir girişim yapılmadan karın duvarı tekrar kapatıldı. İskemi grubu ise laparatomi yapıldıktan sonra Süperior Mezenterik Arter bulunarak bağlanıp Mezenter iskemi modeli oluşturuldu. Her 3 gruptaki hayvanlardan 0, 1, 3 ve 6. saatlerde kan alma işlemi tekrarlandı. Alınan numuneler Amilaz, Fosfor, D-Dimer, Prokalsitonin ve Diamin Oksidaz çalışılmak için kullanıldı.Bulgularİskemi grubunda, serum amilaz, fosfor ve Prokalsitonin düzeyleri zamanla ve Kontrol ve Sham gruplarına göre yüksek olarak saptandı. Bu yükseklik istatistiksel olarak anlamlı bulundu (p<0.05). D-Dimer için yapılan çalışma sonucunda Kontrol ve Sham grubunda aglütinasyon oluşmaz iken İskemi grubunda 6. saatte her 7 denekte de aglütinasyon görüldü. İstatistiksel olarak anlamlı bulundu (p<0.05).İskemi grubunda Serum DAO düzeyleri; 1. saatten itibaren giderek düşme eğiliminde idi. Bu seyir ilerleyen saatlerde de devam etti. DAO seviyelerindeki bu değişiklik istatistiksel olarak anlamlı bulundu (p<0.05).SonuçProkalsitoninin AMİ'nin erken tanısında ve prognozunda kullanılabilecek önemli bir parametre olabileceğini düşünüyoruz. Bu konuda daha ileri deneysel ve klinik çalışmalara ihtiyaç vardır.Amilaz, Fosfor ve D-Dimer; AMİ şüphelenilen vakalarda birlikte bakılması tek başına kullanımından daha değerlidir. DAO barsağa spesifik bir enzim olup ince barsak hücrelerinin hasarında, iskemisinde aktivitesi azalmaktadır. Serum DAO düzeyi mukozal DAO ktivitesi ile paralellik göstermekte olup AMİ erken tanısında kullanımı yaygınlaştırılmalıdır.
In this study, the significance and utilization of levels of serum Diamine Oxydase (DAO), Procalcytonin, D-Dimer, Amylasis and Phosphrus in the early diagnosis of AMI were investigated, using experimental AMI model in rabbits. In addition, while how correlated the investigation of the changes of 4 factors depending on time is correlated with intestinal ischemia was evaluated, whether the factors exhibit superiority to each other and the importance of the utilization of 4 factors together were also investigated.Materials and MethodIn the study, 21 News Zealand rabbit were used. The animals were randomly divided into 3 groups, consisting of 7 in each. These groups were named as the groups of controls, Sham and Ischemia. No intervention was carried out in the rabbits in control group. In rabbits in Sham and Ischemia groups, laparotomy was performed with middle line incision. In Sham group, abdominal wall was restitched after the periton was ignored without performing any other procedures. In Ischemia group, however, after performing laparotomy, Mesenthry Ischemia model was formed, following that Superior Mesenthric Artery was found and tied. From the rabbits in 3 groups, blood was drawn at hours of 0,1,3 and 6.Obtained samples were used to study Amylasis, D-Dimer, Procalcytonin and Diamin Oxydase.ResultsIn Ischemia group, levels of serum Amylasis, Phosphorus and Procalcytonin were found to be higher overtime, compared to controls and Sham group (p < 0.05). As a result of the study performed for D-Dimer, while no agglutination occured in the controls and Sham group, agglutination was observed in also 7 subjects at 6th hour in Ischemia group. The condition was found to be statistically significant (p < 0.05).In Ischemia group, levels of serum DAO tended to decreasingly diminish from 1st hour. The diminishing course also carried on during the following hours. This difference in the levels of DAO was determined to be statistically significant. ( p < 0.05).ConclusionIt is considered that Procalcytonin may be an important parameter in the early diagnosis and prognosis of AMI. Further experimental and clinical studies related to the topic are needed.In AMI-suspected cases, teh assessment of Amylasis, Phosphorus and D-Dimer together is more valuable than the single use of each. DAO is an enzyme specialized with intestines and the activity of which decreases in the injury and ischemia of small intestines. Level of serum DAO indicates parallelism to the mucosal activity of DAO, and its use should be generalized in the early detection of AMI.
In this study, the significance and utilization of levels of serum Diamine Oxydase (DAO), Procalcytonin, D-Dimer, Amylasis and Phosphrus in the early diagnosis of AMI were investigated, using experimental AMI model in rabbits. In addition, while how correlated the investigation of the changes of 4 factors depending on time is correlated with intestinal ischemia was evaluated, whether the factors exhibit superiority to each other and the importance of the utilization of 4 factors together were also investigated.Materials and MethodIn the study, 21 News Zealand rabbit were used. The animals were randomly divided into 3 groups, consisting of 7 in each. These groups were named as the groups of controls, Sham and Ischemia. No intervention was carried out in the rabbits in control group. In rabbits in Sham and Ischemia groups, laparotomy was performed with middle line incision. In Sham group, abdominal wall was restitched after the periton was ignored without performing any other procedures. In Ischemia group, however, after performing laparotomy, Mesenthry Ischemia model was formed, following that Superior Mesenthric Artery was found and tied. From the rabbits in 3 groups, blood was drawn at hours of 0,1,3 and 6.Obtained samples were used to study Amylasis, D-Dimer, Procalcytonin and Diamin Oxydase.ResultsIn Ischemia group, levels of serum Amylasis, Phosphorus and Procalcytonin were found to be higher overtime, compared to controls and Sham group (p < 0.05). As a result of the study performed for D-Dimer, while no agglutination occured in the controls and Sham group, agglutination was observed in also 7 subjects at 6th hour in Ischemia group. The condition was found to be statistically significant (p < 0.05).In Ischemia group, levels of serum DAO tended to decreasingly diminish from 1st hour. The diminishing course also carried on during the following hours. This difference in the levels of DAO was determined to be statistically significant. ( p < 0.05).ConclusionIt is considered that Procalcytonin may be an important parameter in the early diagnosis and prognosis of AMI. Further experimental and clinical studies related to the topic are needed.In AMI-suspected cases, teh assessment of Amylasis, Phosphorus and D-Dimer together is more valuable than the single use of each. DAO is an enzyme specialized with intestines and the activity of which decreases in the injury and ischemia of small intestines. Level of serum DAO indicates parallelism to the mucosal activity of DAO, and its use should be generalized in the early detection of AMI.
Açıklama
Anahtar Kelimeler
Diaminler, Diamines, Diaminoksidaz, Diamine oxidase, Fosfor, Phosphorus, Mezenter, Mesentery, İskemi, Ischemia
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Karabulut, K. U. (2010). Akut mezenter iskemi tanısında yeni belirteçler. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Acil Tıp Anabilim Dalı, Konya.
