Kardiyopulmoner bypass uygulanan hastalarda perioperatif myokard hasarının total ve lipide bağlı sialik asid düzeylerine etkisi
Küçük Resim Yok
Tarih
2005
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Sialik asidin artmış kardiyovasküler mortalite ve serebrovasküler hastalıkla ilişkili bir kardiyovasküler risk faktörü olduğu ileri sürülmüştür. Myokard infarktüsünden sonra serum sialik asid düzeylerinde bir yükselme olduğu bildirilmiş ancak bu yükselmenin sebebi tam olarak aydınlatılamamıştır. Bu çalışmanın amacı total ve lipide bağlı sialik asid düzeylerinin koroner arter hastalığı tedavisi için uygulanan kardiyopulmoner bypass' a bağlı değişimlerini araştırmaktır. Çalışmaya elektif koroner arter bypass ameliyatı uygulanan 20 hasta (14 erkek) dahil edildi. Kan örnekleri anestezi indüksiyonu sırasında (1), kros klamp kaldırıldıktan 20 dk sonra (2) ve postoperatif 3. gün (3) alındı. Örneklerde total sialik asid, lipide bağlı sialik asid, serum protein düzeyi, troponin I, myoglobin ve kreatin kinaz-MB düzeyleri analiz edildi. Total sialik asid iskemi-reperfüzyon periodunda hemodilüsyona bağlı olarak azaldı, ancak postoperatif 3. gün artış gösterdi (p<0.001). Lipide bağlı sialik asid 2. ve 3. örneklerde başlangıç değerlerine göre yüksekti (p<0.001). Kardiyak belirteçler orta derecede yükseldi (p<0.001). Perioperatif dönemde myokard infarktüsü ve ölüm görülmedi. Total sialik asidin geç dönemde yükselmesi akut faz yanıtı ile ilişkili gibi görünmektedir. Lipide bağlı sialik asid erken dönemde yükselmesi nedeniyle iskemi reperfüzyon hasarına total sialik aside göre daha duyarlı olabilir. Bu konu ileri araştırmayı gerektirmektedir. Anahtar kelimeler: Sialik asid, Kardiyopulmoner bypass, Koroner arter hastalığı 46
THE EFFECT OF PERIOPERATIVE MYOCARDIAL INJURY TO TOTAL AND LIPID BOUND SIALIC ACID LEVELS IN PATIENTS UNDERGOING CARDIOPULMONARY BYPASS SUMMARY Sialic acid has been proposed to be a cardiovascular risk factor, with elevated levels associated with increased cardiovascular mortality and also with cerebrovascular disease. It has also been reported that sialic acid concentration is increased after myocardial infarction but the reason for this elevation remains obscure. The aim of the present study was to investigate whether serum total sialic acid and lipid bound sialic acid were associated with the cardiopulmonary bypass for the treatment of coronary artery disease. Twenty patients (14 male) underwent elective coronary artery bypass grafting were included in the study. Blood samples were obtained in the induction of anesthesia(l), 20 seconds after declamping (2) and at the postoperative 3rd day (3). Total sialic acid, lipid bound sialic acid, serum protein, troponin I, myoglobin and creatine kinase- MB levels were analyzed in the samples. Total sialic acid levels were decreased after ischemia-reperfusion period due to hemodilution, but were elevated at the 3rd day, postoperatively (p<0.001). Lipid bound sialic acid levels were elevated in 2. and 3. groups of samples (p<0.001). Cardiac markers were elevated (p<0.001). However, myocardial infarction and death were not observed. Total sialic acid elevation may be related with acute phase response. Lipid bound sialic acid may be more sensitive than total sialic acid for ischemia-reperfusion injury. It is required further investigation in this matter. Key words : Sialic acid, Cardiopulmonary bypass, Coronary artery disease 47
THE EFFECT OF PERIOPERATIVE MYOCARDIAL INJURY TO TOTAL AND LIPID BOUND SIALIC ACID LEVELS IN PATIENTS UNDERGOING CARDIOPULMONARY BYPASS SUMMARY Sialic acid has been proposed to be a cardiovascular risk factor, with elevated levels associated with increased cardiovascular mortality and also with cerebrovascular disease. It has also been reported that sialic acid concentration is increased after myocardial infarction but the reason for this elevation remains obscure. The aim of the present study was to investigate whether serum total sialic acid and lipid bound sialic acid were associated with the cardiopulmonary bypass for the treatment of coronary artery disease. Twenty patients (14 male) underwent elective coronary artery bypass grafting were included in the study. Blood samples were obtained in the induction of anesthesia(l), 20 seconds after declamping (2) and at the postoperative 3rd day (3). Total sialic acid, lipid bound sialic acid, serum protein, troponin I, myoglobin and creatine kinase- MB levels were analyzed in the samples. Total sialic acid levels were decreased after ischemia-reperfusion period due to hemodilution, but were elevated at the 3rd day, postoperatively (p<0.001). Lipid bound sialic acid levels were elevated in 2. and 3. groups of samples (p<0.001). Cardiac markers were elevated (p<0.001). However, myocardial infarction and death were not observed. Total sialic acid elevation may be related with acute phase response. Lipid bound sialic acid may be more sensitive than total sialic acid for ischemia-reperfusion injury. It is required further investigation in this matter. Key words : Sialic acid, Cardiopulmonary bypass, Coronary artery disease 47
Açıklama
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Tıpta Uzmanlık
Tıpta Uzmanlık
Anahtar Kelimeler
Biyokimya, Biochemistry
