Koroziv özofagus oluşturulan ratlarda subakut yara iyileşmesinde alfa lipoik asitin metilprednisolon ve sukralfatla karşılaştırmalı çalışması (deneysel çalışma)
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Tarih
2009
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Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Koroziv maddelerin özellikle alkali solüsyonların yanlışlıkla veya suisit amaçlı içilmesi özofagusta yanık sonucu ülser, perforasyon veya ölümle sonuçlanabilen ciddi sağlık problemlerine neden olabilmesi sebebiyle günümüzde ciddi bir sağlık problemi oluşturmaktadır. Koroziv özofagus yanığında yapılan çeşitli klinik ve deneysel çalışmalar ile koroziv özofagus darlığının azaltılması amaçlanmıştır. Bizde çalışmamızda KÖY sonrası subakut dönem yara iyileşmesinde kuvvetli bir antioksidan olan alfa lipoik asit'i, halen KÖY tedavisinde kullanılan metilprednisolounu, mukoza koruyucu özelliği olan sukralfat tedavisinin etkinliğini karşılaştırmayı amaçladık.Çalışmada 40 adet 8-10 haftalık dişi spraque-dawley dişi sıçan kullanıldı. Sıçanlar eşit sayıda olmak üzere dört gruba ayrıldı (N=10). Birinci grup kontrol, ikinci grup alfa lipoik asit, üçüncü grup metilprednisolon ve dördüncü grup sukralfat grubu idi. Bütün gruplarda %10'luk pH:12 NaOH ile KÖY oluşturuldu. Kontrol grubuna tedavi verilmezken, ALA grubuna 100 mg/kg/gün intraperitoneal ALA, metilprednisolon grubuna 30 mg/kg/gün metilprednisolon ve sukralfat grubuna 150 mg/kg/gün sukralfat tedavisi postoperatif dönemde başlandı ve sakrifiye edilen gün dahil olmak üzere tedavileri düzenli olarak verildi. Sekizinci gün tüm gruplar kan GSH düzeyi için örnekleme alındıktan sonra sakrifiye edildi ve KÖY oluşturulan segment histopatolojik inceleme ve doku hidroksiprolin ölçümü için çıkarıldı.Sonuç olarak, ALA'nın koroziv özofagusta subakut dönemde ülserasyonu, inflamasyon şiddetini ve yaygınlığını, fibrozis şiddeti ve yaygınlığını azaltığını, kan GSH düzeyini arttırdığını böylelikle doku hasarını azalttığı ve uzun dönem sonuçlarında striktürü azaltacağı kanaatindeyiz. Halen klinik deneyimlerinde kullanılmakta olan steroid tedavisinin subakut dönemde yara iyileşmesini bozması nedeni ile kullanılmaması gerektiğini düşünmekteyiz. Deneysel olarak kullandığımız ALA'nın KÖY vakalarında kullanılması için ileri klinik çalışmaların yapılması gerekmektedir.
Accidental or suicidal ingestion of corrosive substances, particularly alkali solutions, constitutes a serious health problem in our day, since such ingestions may cause significant health problems that might result in the ulceration of the oesophagus following corrosive burns, perforation or even death. It was aimed to decrease esophageal stenosis in various clinical and experimental studies conducted on the corrosive burns of the oesophagus (CBO). In our study, we aimed to compare alpha lipoic acid, which is a strong antioxidant used in wound healing in the subacute period following CBO, methyl-prednisolone, which is still being used in the treatment of CBO and sucralfate, which has a protective effect on the mucous membrane.Forty 8-10 weeks of age female Sprague-Dawley rats were used in the study. The rats were divided into four groups, each of which consisted of 10 rats. The first group was assigned as the control group, the second was the alpha lipoic acid, the third was the methyl-prednisolone, and the fourth was the sucralfate group. Corrosive burns of the oesophagus were produced in all the groups by using 10% pH:12 NaOH. While the control group was not treated, the second group was given intraperitoneal 100 mg/kg/day ALA, the third group was given methyl-prednisolone 30 mg/kg/day and the fourth group was given sucralfate treatment 150 mg/kg/day. The treatments started in the postoperative period and were given regularly including the day the subjects were sacrificed. All groups were sacrificed on the 8th day after samples were taken to measure the blood GSH levels, and the segment with corrosive burns of the oesophagus was extracted for histopathological examination and the measurement of tissue hydroxyproline.In conclusion, we are of the opinion that ALA decreases the ulceration of the oesophagus, the intensity and prevalence of inflammation and the intensity and prevalence of fibrosis, increases blood GSH level and thus decreases tissue damage and also will decrease stricture in the long term following corrosive burns of the oesophagus. We think that steroid treatment, which is still being used in clinical experimentations, should not be used since it disrupts wound healing in the subacute period. Further clinical studies should be conducted for the use of ALA in cases of CBO, which we used experimentally.
Accidental or suicidal ingestion of corrosive substances, particularly alkali solutions, constitutes a serious health problem in our day, since such ingestions may cause significant health problems that might result in the ulceration of the oesophagus following corrosive burns, perforation or even death. It was aimed to decrease esophageal stenosis in various clinical and experimental studies conducted on the corrosive burns of the oesophagus (CBO). In our study, we aimed to compare alpha lipoic acid, which is a strong antioxidant used in wound healing in the subacute period following CBO, methyl-prednisolone, which is still being used in the treatment of CBO and sucralfate, which has a protective effect on the mucous membrane.Forty 8-10 weeks of age female Sprague-Dawley rats were used in the study. The rats were divided into four groups, each of which consisted of 10 rats. The first group was assigned as the control group, the second was the alpha lipoic acid, the third was the methyl-prednisolone, and the fourth was the sucralfate group. Corrosive burns of the oesophagus were produced in all the groups by using 10% pH:12 NaOH. While the control group was not treated, the second group was given intraperitoneal 100 mg/kg/day ALA, the third group was given methyl-prednisolone 30 mg/kg/day and the fourth group was given sucralfate treatment 150 mg/kg/day. The treatments started in the postoperative period and were given regularly including the day the subjects were sacrificed. All groups were sacrificed on the 8th day after samples were taken to measure the blood GSH levels, and the segment with corrosive burns of the oesophagus was extracted for histopathological examination and the measurement of tissue hydroxyproline.In conclusion, we are of the opinion that ALA decreases the ulceration of the oesophagus, the intensity and prevalence of inflammation and the intensity and prevalence of fibrosis, increases blood GSH level and thus decreases tissue damage and also will decrease stricture in the long term following corrosive burns of the oesophagus. We think that steroid treatment, which is still being used in clinical experimentations, should not be used since it disrupts wound healing in the subacute period. Further clinical studies should be conducted for the use of ALA in cases of CBO, which we used experimentally.
Açıklama
Anahtar Kelimeler
Alfa lipoik asit, koroziv özofagus, striktür, metilprednisolon, sukralfat, Alpha lipoic acid, corrosive esophagus, stricture, methylprednisolone, sucralfate
Kaynak
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Cilt
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Künye
Gültekin, M. (2009). Koroziv özofagus oluşturulan ratlarda subakut yara iyileşmesinde alfa lipoik asitin metilprednisolon ve sukralfatla karşılaştırmalı çalışması (deneysel çalışma). (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Göğüs Cerrahisi Anabilim Dalı, Konya.
