Deneysel sepsis geliştirilen ratlarda prokinetik ajanların gastrointestinal sistem transit zamanı üzerine etkisi
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Tarih
2011
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Trakya Üniversitesi Tıp Fakültesi
Trakya Üniversitesi Tıp Fakültesi
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sepsis, gastrointestinal sistem motilite fonksiyonlarında yaptığı değişimler ve açığa çıkan sitokinler ile birlikte multiple organ yetmezliği gelişiminde rol oynaması nedeniyle, günümüzde halen yüksek mortalite ile seyreden tedavisi güç bir klinik tablodur. Çalışmamızda deneysel sepsis geliştirilen ratlarda prokinetik ajanların gastrointestinal sistem geçiş zamanı üzerine etkileri ve erken yanıt sitokinleri üzerine etkisini araştırdık. Çalışmada 190-250 gr ağırlığında, 40 adet dişi Sprague-Dawley rat kullanıldı ve toplam 4 grup oluşturuldu. Grup 1: kontrol grubu (n=10), grup 2: sepsis grubu (n=10), grup 3: sepsis + neostigmin verilen grup (n=10), grup 4: sepsis + metoklopramit verilen grup (n=10). Sepsis oluşturmak için grup 2, 3 ve 4'e intravenöz Escherichia coli serotyp 0111; B4 suşu 1x108 Colony Forming Unit verildi. Sepsis oluşturulduktan 8 saat sonra tüm gruplara anestezi uygulandı ve grup 3'teki ratlara intravenöz 1mg/kg neostigmin, grup 4'teki ratlara intravenöz 5mg/kg metoklopramit verildi, 30 dakika sonra tüm gruplara 1mCi Tc99m işaretli mebrofenin intravenöz yoldan uygulanarak tek başlı pinhol kolimatör takılı gama kamera ile dinamik sintigrafik çalışma yapılarak karaciğer pik zamanı, duodenum görünme zamanı, çekum görünme zamanı ve ince bağırsak geçiş zamanı ölçüldü. Ölçüm sonrası tüm ratların serum örnekleri alındı ve tümör nekrozis faktör - alfa, interlökin ? bir beta ve interlökin - altı düzeyleri çalışıldı. Sepsis grubunda (grup 2) karaciğer pik zamanı, duodenum görünme zamanı, çekum görünme zamanı ve ince bağırsak geçiş zamanı diğer gruplarla karşılaştırıldığında istatistiksel olarak anlamlı derecede yüksek bulundu. Grup 3 ve grup 4'te ise çekum görünme zamanı ve ince bağırsak geçiş zamanının sepsis grubuna göre istatistiksel olarak anlamlı derecede azaldığı saptandı (p<0.05). Sepsis grubunda interlökin ? bir beta ve interlökin - altı düzeyleri diğer gruplara göre istatistiksel olarak anlamlı derecede yüksek bulunurken (p=0.001), tümör nekrozis faktör - alfa düzeyleri diğer gruplara göre yüksek tespit edilmiş ancak istatistiksel olarak anlamlı bulunmamıştır. Grup 3 ve grup 4'te tümör nekrozis faktör - alfa, interlökin ? bir beta ve interlökin - altı düzeylerinin sepsis grubuna göre önemli ölçüde azaldığı görüldü, fakat istatistiksel olarak anlamlı derecede azalma; grup 4'teki interlökin ? bir beta düzeylerinde tespit edildi (p<0.05).
Abstract
With the changes it causes in the gastrointestinal motility functions and the cytokines formed therewith and the role it plays in multiple organ dysfunction sepsis is still a high mortality difficult to treat clinical condition. In our study, we investigated the effects of prokinetic agents on the gastrointestinal transit time in rats with experimentally induced sepsis and whether these agents had any effects on the early-response cytokine levels. Forty female Sprague-Dawley rats weighing between 190 and 250 grams included in the study were randomized into 4 groups. The 4 groups formed consisted of a control group (Group 1; n=10), a sepsis group (Group 2; n=10), a sepsis group administered with neostigmine (Group 3; n=10) and a sepsis group administered with metoclopramide (Group 4; n=10). In groups 2, 3 and 4 sepsis was induced through administration of intravenous Escherichia coli serotype 0111;B4 strain 1 x 108 Colony Forming Unit. 8 hours after the onset of sepsis rats in all groups were anaesthesised and rats in groups 3 and 4 were intravenously administered with 1mg/kg Neostigmine and 5mg/kg metoclopramide respectively. After 30 minutes, all anaesthesized rats were intravenously administered with 1mCi Tc99 mebrofenin and then evaluated for peak liver uptake time, duodenum and caecum appearance times, and small intestine transit time using a gamma camera with a single pinhole collimator in a dynamic scintigraphy workup. After these measurements serum samples were taken from all the rats in the trial and tumor necrosis factor - alpha, ınterleukin ? one beta and ınterleukin - six levels were evaluated. In the sepsis group (Group 2) the peak liver time the duodenum and caecum appearance times and the small intestine transit time were found to be statistically longer compared to the other groups in the trial. Compared to the sepsis group the caecum manifestation and the small intestine transit times were found to be statistically shorter in groups 3 and 4 (p<0.05). ınterleukin ? one beta and ınterleukin - six levels were found to be statistically higher in the sepsis group compared to the other groups (p=0,001), tumor necrosis factor - alpha levels were also found to be higher in the sepsis group compared to the other groups although they did not carry any statistical significance. Compared to the sepsis group tumor necrosis factor - alpha, ınterleukin ? one beta and ınterleukin - six levels were significantly lower in groups 3 and 4, although a statistically significant decrease was only observed in the ınterleukin ? one beta levels in group 4 (p<0.05).
Abstract
With the changes it causes in the gastrointestinal motility functions and the cytokines formed therewith and the role it plays in multiple organ dysfunction sepsis is still a high mortality difficult to treat clinical condition. In our study, we investigated the effects of prokinetic agents on the gastrointestinal transit time in rats with experimentally induced sepsis and whether these agents had any effects on the early-response cytokine levels. Forty female Sprague-Dawley rats weighing between 190 and 250 grams included in the study were randomized into 4 groups. The 4 groups formed consisted of a control group (Group 1; n=10), a sepsis group (Group 2; n=10), a sepsis group administered with neostigmine (Group 3; n=10) and a sepsis group administered with metoclopramide (Group 4; n=10). In groups 2, 3 and 4 sepsis was induced through administration of intravenous Escherichia coli serotype 0111;B4 strain 1 x 108 Colony Forming Unit. 8 hours after the onset of sepsis rats in all groups were anaesthesised and rats in groups 3 and 4 were intravenously administered with 1mg/kg Neostigmine and 5mg/kg metoclopramide respectively. After 30 minutes, all anaesthesized rats were intravenously administered with 1mCi Tc99 mebrofenin and then evaluated for peak liver uptake time, duodenum and caecum appearance times, and small intestine transit time using a gamma camera with a single pinhole collimator in a dynamic scintigraphy workup. After these measurements serum samples were taken from all the rats in the trial and tumor necrosis factor - alpha, ınterleukin ? one beta and ınterleukin - six levels were evaluated. In the sepsis group (Group 2) the peak liver time the duodenum and caecum appearance times and the small intestine transit time were found to be statistically longer compared to the other groups in the trial. Compared to the sepsis group the caecum manifestation and the small intestine transit times were found to be statistically shorter in groups 3 and 4 (p<0.05). ınterleukin ? one beta and ınterleukin - six levels were found to be statistically higher in the sepsis group compared to the other groups (p=0,001), tumor necrosis factor - alpha levels were also found to be higher in the sepsis group compared to the other groups although they did not carry any statistical significance. Compared to the sepsis group tumor necrosis factor - alpha, ınterleukin ? one beta and ınterleukin - six levels were significantly lower in groups 3 and 4, although a statistically significant decrease was only observed in the ınterleukin ? one beta levels in group 4 (p<0.05).
Açıklama
Yüksek Lisans Tezi
Anahtar Kelimeler
Deneysel Sepsis, Gastrointestinal Geçiş Zamanı, Prokinetik Ajanlar, Experimentally Induced Sepsis, Gastrointestinal Transit Time, Prokinetic Agents
