Sertralin uygulanmasının kalbin kasılma gücü üzerine etkisinin araştırılması: In vitro model
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmanın amacı, postoperatif erken dönem kalp hastalarında sık karşılaşılan depresyonun önlenmesi / tedavisinde ve kalbin kontraksiyon gücünün düzenlenmesinde, sertralinle kombine edilen ve antioksidan bir iyon olan Mg+²'nin sinerjik etkilerinin tespit edilmesidir. Çalışma Necmettin Erbakan Üniversitesi KONÜDAM Deneysel Tıp Araştırma ve Uygulama Merkezi'nden temin edilen deney hayvanları kullanılarak, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Fizyoloji Anabilim Dalı Laboratuarı'nda yapılmıştır. Araştırmamızda erişkin (10 aylık, 200-350 gram ağırlığında) erkek Wistar Albino cinsi ratlar kullanılmıştır. Toplam 40 adet rat olmak üzere rastgele 6 gruba ayrılmıştır ve dağılımları rastgele belirlenmiştir. İlk 4 grupta hafif eter anestezisi altında hayvanların kalplerinden alınan kanın plazması ayrılarak -20 0 C saklanmıştır. Aynı zamanda lanset yardımıyla pıhtılaşma zamanlarına bakılmıştır. Atriyumdan kesilen 3-4 milimetre uzunluğundaki şeritler transvers düzlemde içinde krebs solüsyonu olan izole organ banyosundaki kancalara yerleştirilmiş ve gerim 2 g olarak ayarlanmıştır. İzometrik kontraksiyonlar 0,001 M adrenalin ile indüklenip, 1. grup sadece gözlemlenmiş. 2. gruba kümülatif sertralin (10-9 ve 10⁻4 M), 3. gruba kümülatif Magnezyum Sülfat (MgSO4 ) (0.1, 1, 2, 4, 8,10 mmol/L), 4. gruba kümülatif sertralin ve kümülatif MgSO4 10'ar dakika arayla ilave edilerek kasılmalarında meydana gelen değişiklikler kaydedilmiştir. 5. gruba dekapitasyon öncesi 29 gün 10 mg/kg/gün sertralin enjeksiyonu, 6. gruba da 14 gün boyunca 20 mg/kg/gün MgSO4 enjeksiyonu yapılmış, bu sürede ağırlıklarda meydana gelen değişimler kaydedilmiştir. 5. ve 6. grup dekapitasyon sonrası kontrol grubu ile aynı işlemlere tabi tutulmuştur. Ağırlık, pıhtılaşma süresi, biyokimyasal bulgularda ve gerimlerde meydana gelen değişimler istatistiksel olarak değerlendirilmiştir. Kontrol grubu ile kümülatif MgSO4 arasındaki gerimler arası ilişki 4 mmol/L MgSO4 verildiği anda anlamlı olmaya başlamıştır (p<0.05). Kontrol grubu ile kümülatif sertralin grubu arasında gerimler arası ilişkide anlamlı bir farklılık gözlenmemiştir. Kümülatif sertralin ve kümülatif MgSO4 grupları arasındaki gerim ilişkisi sertralinin 10-5 M ve MgSO4'ün 8 mmol/L verildiği anda anlamlı olmaya başlamıştır. Kümülatif sertralin ve kümülatif MgSO4 'ın art arda verildiği izole organ banyosunda gerimde hızlı bir inhibasyon gözlenmiştir. Sertralinin yirmidokuz gün ve magnezyumun ondört gün enjeksiyonu sonrası spontan kasılmalar üzerine etkileri birbirine yakın değerlerde istatistiksel olarak anlamlı bulunmuştur (p<0.05). Enjeksiyon yapılan ratların ağırlıkları arasında başlangıç durumuna göre istatistiksel olarak anlamlı bir farklılık gözlenmemiştir. Kan pıhtılaşma süreleri gruplar birbiriyle kıyaslandığında MgSO4 verilen grupta pıhtılaşma sürelerinin saniyelerle sınırlı olduğu ve istatistiksel olarak anlamlı bir azalış gösterdiği bulunmuştur. Kontrol grubuna kıyasla kan yağlarında olumlu bir düşüş olduğu sadece trigliseritlerin sertralin uygulanan grupta biraz yükseldiği belirlenmiştir. Plazma enzimlerinin bazılarında yükselme gözlenirken, Nt-BNP ve inflamatuar yanıtta büyük bir değişim gözlenmemiştir. Postoperatif depresyon tedavisinde antidepresanlar eşliğinde MgSO4 kullanımı pıhtılaşma süresini kısalttığı için ölümcül riskler doğurabilir. Bu nedenle antidepresanlarla MgSO4' ün birlikte kullanımına dikkat edilmelidir. Magnezyum koroner bypass ameliyatı sonrası arteriol greftlerde vazospazmı inhibe etmek için sertraline yardımcı olabilir. Ancak pıhtılaşma süresini kısaltması emboli riskini artırabilir. Ameliyat öncesinde postopetarif depresyon riskini azaltmak için preoperatif dönemde antidepresanlar yerine doğal bir destek olarak düşünülebilmesi için daha fazla çalışmaya ihtiyaç bulunmaktadır.
The aim of this study was to determine the synergistic effects of Mg+2, an antioxidant ion, combined with sertraline, in the treatment or prevention of major depression in early postoperative period and in regulation of contraction strength of the heart. The study was conducted in Necmettin Erbakan University, Meram Medical Faculty, Department of Physiology, using experimental animals obtained from Experimental Medicine Research and Application Center of KONUDAM. In our study adult Wistar Albino rats (10 months old, weighing 200-350 grams) were used. There were 6 groups including 40 animals and their distribution was randomly determined. In the first 4 groups, blood plasma taken from the heart tissues of rats under mild ether anesthesia was separated and stored at -20 °C. At the same time, clotting times were also examined with the help of lancet. The 3- 4 millimeter long strips cut from rat atriums were placed in hooks of isolated organ bath with crebs solution in the transverse plane and the tension was adjusted to 2 g. Isometric contractions were induced with 0.001 M adrenaline and observed only in group 1. The second group was cumulative sertraline (10-9 and 10-4 M), the third group was cumulative Magnesium Sulphate (MgSO4) (0.1, 1, 2, 4, 8, 10 mmol/L), the fourth group was cumulative sertraline and cumulative MgSO4, changes in contractions were recorded in every 10 minutes intervals. The fifth group received 10 mg/kg/day sertraline injection for twenty-nine days before decapitation and the sixth group received 20 mg/kg/day MgSO4 injection for fourteen days, during which time changes in weights were recorded. The 5th and 6th groups were subjected to the same procedures as the control group after decapitation. Changes in weight, clotting time, biochemical findings and strains were evaluated statistically. The relationship between the stresses between control group and cumulative MgSO4 started to be significant when 4 mmol/L MgSO4 was given (p <0.05). There was no significant difference between the control and cumulative sertraline groups in the relationship between strains. Strain relationship between cumulative sertraline and cumulative MgSO4 groups started to be significant when sertraline 10-5 M and MgSO4 were given 8 mmol/L. A rapid inhibition of strain was observed in isolated organ bath, where cumulative sertraline and cumulative MgSO4 were given consecutively. The effects of sertraline on spontaneous contractions of 29 days and magnesium after 14 days of injection were found to be statistically significant (p<0.05). There was no statistically significant difference observed between the weights of injected rats according to baseline. When clotting times were compared with each other, it was found that clotting times were limited to seconds and istatistically significant decrease was observed in MgSO4 treated group. There was a significant decrease in blood fats compared to control group, but only triglycerides increased slightly in sertraline treated group. An increase in cardiac enzymes was observed, while no significant change was observed in Nt-BNP and inflammatory response. The use of MgSO4 with antidepressants in the treatment of postoperative depression may lead to fatal risks as it shortens the clotting time. Therefore, the use of antidepressants and MgSO4 should be considered. Magnesium may help sertraline to inhibit vasospasm in arteriole grafts after coronary bypass surgery. However, shortening clotting time may increase the risk of embolism. In order to reduce the risk of post-operative depression preoperatively, more studies are needed to be thought as a natural antioxidant rather than antidepressants in the preoperative period.
The aim of this study was to determine the synergistic effects of Mg+2, an antioxidant ion, combined with sertraline, in the treatment or prevention of major depression in early postoperative period and in regulation of contraction strength of the heart. The study was conducted in Necmettin Erbakan University, Meram Medical Faculty, Department of Physiology, using experimental animals obtained from Experimental Medicine Research and Application Center of KONUDAM. In our study adult Wistar Albino rats (10 months old, weighing 200-350 grams) were used. There were 6 groups including 40 animals and their distribution was randomly determined. In the first 4 groups, blood plasma taken from the heart tissues of rats under mild ether anesthesia was separated and stored at -20 °C. At the same time, clotting times were also examined with the help of lancet. The 3- 4 millimeter long strips cut from rat atriums were placed in hooks of isolated organ bath with crebs solution in the transverse plane and the tension was adjusted to 2 g. Isometric contractions were induced with 0.001 M adrenaline and observed only in group 1. The second group was cumulative sertraline (10-9 and 10-4 M), the third group was cumulative Magnesium Sulphate (MgSO4) (0.1, 1, 2, 4, 8, 10 mmol/L), the fourth group was cumulative sertraline and cumulative MgSO4, changes in contractions were recorded in every 10 minutes intervals. The fifth group received 10 mg/kg/day sertraline injection for twenty-nine days before decapitation and the sixth group received 20 mg/kg/day MgSO4 injection for fourteen days, during which time changes in weights were recorded. The 5th and 6th groups were subjected to the same procedures as the control group after decapitation. Changes in weight, clotting time, biochemical findings and strains were evaluated statistically. The relationship between the stresses between control group and cumulative MgSO4 started to be significant when 4 mmol/L MgSO4 was given (p <0.05). There was no significant difference between the control and cumulative sertraline groups in the relationship between strains. Strain relationship between cumulative sertraline and cumulative MgSO4 groups started to be significant when sertraline 10-5 M and MgSO4 were given 8 mmol/L. A rapid inhibition of strain was observed in isolated organ bath, where cumulative sertraline and cumulative MgSO4 were given consecutively. The effects of sertraline on spontaneous contractions of 29 days and magnesium after 14 days of injection were found to be statistically significant (p<0.05). There was no statistically significant difference observed between the weights of injected rats according to baseline. When clotting times were compared with each other, it was found that clotting times were limited to seconds and istatistically significant decrease was observed in MgSO4 treated group. There was a significant decrease in blood fats compared to control group, but only triglycerides increased slightly in sertraline treated group. An increase in cardiac enzymes was observed, while no significant change was observed in Nt-BNP and inflammatory response. The use of MgSO4 with antidepressants in the treatment of postoperative depression may lead to fatal risks as it shortens the clotting time. Therefore, the use of antidepressants and MgSO4 should be considered. Magnesium may help sertraline to inhibit vasospasm in arteriole grafts after coronary bypass surgery. However, shortening clotting time may increase the risk of embolism. In order to reduce the risk of post-operative depression preoperatively, more studies are needed to be thought as a natural antioxidant rather than antidepressants in the preoperative period.
Açıklama
Yüksek Lisans Tezi
Anahtar Kelimeler
Atriyum, İzole organ banyosu, Magnezyum sülfat, Rat, Sertralin, Atrium, Isolated organ bath, Magnesium sulfate, Sertraline
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Fidan, E. (2019). Sertralin uygulanmasının kalbin kasılma gücü üzerine etkisinin araştırılması: In vitro model. (Yayınlanmamış Yüksek Lisans Tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Fizyoloji Anabilim Dalı, Konya.
