Akut mezenter iskemide plazma D-dimer düzeyleri ve biyokimyasal parametrelerin zamana bağlı değişimi : Deneysel çalışma
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Tarih
2012
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info:eu-repo/semantics/openAccess
Özet
Akut mezenter iskemi akut karına yol açan, tanıdaki gecikmeye bağlı prognozu oldukça kötü bir patolojidir. Bu çalışmada, D-dimer ve biyokimyasal parametrelerin akut mezenter iskemide zamana bağlı değişimlerini inceleyerek erken tanıda önemini araştırmayı amaçladık. Çalışmada Wistar-Albino cinsi kırk adet erkek rat dört gruba ayrıldı. Kontrol grubuna sadece laparatomi ve mezenter arter diseksiyonu yapıldı. Diğer gruplarda ise laparotomi ve süperiyor mezenter arter bağlanarak 2, 4 ve 6 saat süreyle iskemi oluşturuldu. Ratlardan D-dimer ve biyokimyasal parametrelerin serum düzeylerine bakmak için kan örnekleri alındı. Histopatolojik incelemede iskemi düzeylerini belirlemek için ileumdan örnek alındı. Kontrol grubu ile iki, dört ve altı saatlik iskemi grupları arasında D-dimer ve biyokimyasal parametrelerden alanin aminotransferaz, aspartat aminotransferaz, laktat dehidrogenaz, kreatin fosfokinaz ve fosfat açısından anlamlı farklılıklar bulundu (p<0.05). Alkalen fosfataz değerleri açısından anlamlı farklılık saptanmadı (p>0.05). İskemi süresi arttıkça D-dimer ve biyokimyasal parametre değerlerinin arttığı ve gruplar arasında anlamlı farklılık olduğu gözlendi (p<0.05). Histopatolojik incelemede, iskemi süresinin artışıyla paralel olarak, oluşan iskemik hasarın anlamlı düzeyde artıp derinleştiği saptandı. Daha ileri klinik ve deneysel çalışmalarla desteklendiği takdirde D-dimer ve biyokimyasal parametreler, akut mezenter iskeminin erken tanısında belirteç olarak faydalı olabilir.
Acute mesenteric ischemia is a pathology leading to acute abdomen with a very poor prognosis when there is a delay in diagnosis. In this study we aimed to investigate the importance of D-dimer levels and biochemical parameters in early diagnosis of acute mesentheric ischemia by assessing time-dependent variations of these parameters. Forty Wistar-Albino male rats were divided into four groups. Only laparotomy and mesenteric arterial dissection were made in the control group. In the other groups laparotomy was performed, and ischemia was constituted for 2, 4 and 6 hours by ligating mesenteric artery. Blood samples were taken for measuring serum levels of D-dimer and biochemical parameters in rats. Intestinal tissue samples were obtained from ileum to assess the level of ischemia in histopathological examination. There were significant differences between the control and 2-, 4- and 6-hour ischemia groups regarding D-dimer levels and biochemical parameters such as alanine aminotransferase, aspartate aminotransferase, lactic dehydrogenase, creatine phosphokinase and phosphate (p<0.05). There was no statistically signifant difference with respect to alkaline phosphatase levels (p>0.05). D-dimer levels and biochemical parameters increased in correlation with the duration of ischemia, and there were significant differences between the groups (p<0.05). A significantly deeper ichemic injury was observed in correlation with the duration of ischemia in histopathologic examination. Measurement of D-dimer levels and some biochemical parameters studied in this study may be useful in the early diagnosis of acute mesenteric ischemia provided that our findings are supported with further clinical and experimental studies.
Acute mesenteric ischemia is a pathology leading to acute abdomen with a very poor prognosis when there is a delay in diagnosis. In this study we aimed to investigate the importance of D-dimer levels and biochemical parameters in early diagnosis of acute mesentheric ischemia by assessing time-dependent variations of these parameters. Forty Wistar-Albino male rats were divided into four groups. Only laparotomy and mesenteric arterial dissection were made in the control group. In the other groups laparotomy was performed, and ischemia was constituted for 2, 4 and 6 hours by ligating mesenteric artery. Blood samples were taken for measuring serum levels of D-dimer and biochemical parameters in rats. Intestinal tissue samples were obtained from ileum to assess the level of ischemia in histopathological examination. There were significant differences between the control and 2-, 4- and 6-hour ischemia groups regarding D-dimer levels and biochemical parameters such as alanine aminotransferase, aspartate aminotransferase, lactic dehydrogenase, creatine phosphokinase and phosphate (p<0.05). There was no statistically signifant difference with respect to alkaline phosphatase levels (p>0.05). D-dimer levels and biochemical parameters increased in correlation with the duration of ischemia, and there were significant differences between the groups (p<0.05). A significantly deeper ichemic injury was observed in correlation with the duration of ischemia in histopathologic examination. Measurement of D-dimer levels and some biochemical parameters studied in this study may be useful in the early diagnosis of acute mesenteric ischemia provided that our findings are supported with further clinical and experimental studies.
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Genel ve Dahili Tıp
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Cilt
54
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1
