Akut Karın Hastalarında Ameliyat Öncesi ve Ameliyat Sonrası Tiyol-Disülfid Düzeylerinin Karşılaştırılması

Year 2023, Volume: 13 Issue: 2, 247 - 250, 22.03.2023

Altan Aydın , Hakan Buluş , Alper Yavuz , Mehmet Berksun Tutan , Murat Alışık , Özcan Erel

https://doi.org/10.16899/jcm.1244258

Abstract

Amaç: Akut karın takibinde yeni bir oksidatif stres belirteci olan tiyol ve disülfit homeostazının rolünü araştırmak.
Gereç ve Yöntem: Bu çalışma prospektif olarak planlanmıştır. Bu çalışmaya akut karın(AK) tanılı 107 (62 erkek ve 45 kadın) hasta dahil edildi.107 hastanın yaşı, cinsiyeti, akut karın sebepleri, pre-operatif yatış anındaki ve post-operatif 3. gündeki native thiol (-SH), total thiol (tSH) ve disülfit (-S-S-) seviyeleri prospektif olarak kaydedilmiş ve –SS-/-SH, -S-S -/tSH, -SH/tSH oranları hesaplanmıştır
Bulgular: Akut karına neden olan sebepler incelendiğinde 72 hasta (67,29%) apandisit, 5 hasta (4,67%) alt GIS perforasyonu, 7 hasta (6,54%) peptik ulcus perforasyonu, 5 hasta (4,67%) sigmoid volvulus, 4 hasta (3,74%) strangüle herni, 14 hasta ise (13,08%) diğer nedenlerden opere olmuştu. Hastaların thiol ve disülfit seviyeleri tek parametre olarak incelendiğinde pre-operatif dönemde thiol düzeyi ortalaması 316,71±78,16 (327,5) iken post-operatif dönemde ortalama 264,00±72,85 (278,30) olarak hesaplandı, istatistiki anlamlı farklılık gösterecek şekilde post-operatif dönemde azalma saptandı (p<0,001).Thiol ve disülfit düzeylerinin birbirleri ile oranlarına bakıldığında pre-operatif dönemde disülfit/thiol oranı ortalaması 5,17±1,56 (5,16) iken post-operatif dönemde ortalama 5,36±2,45 (5,28) olarak hesaplandı, istatistiki anlamlı farklılık gözlemlenmedi (p=0,563).
Sonuç: Bu çalışma AK'lı hastalarda tiyol oksidasyonunun bir sonucu olarak ortaya çıkan bu parametrelerin takibinin, gerek preoperatif ve gerekse postoperatif donemde önem arz ettiği bulundu. Bu yeni oksidatif stres belirtecinin diğer yerleşik yaklaşımlarla birlikte kullanımını optimize etmek için daha ileri çalışmalar gereklidir.

Keywords

akut karın, disülfid, laboratuvar çalışması, tiyol

Comparison of Pre-Operative and Post-Operative Thiol-Disulfide Levels in Acute Abdomen Patients

Abstract

Aim: To evaluate role of thiol and disulfide homeostasis, a novel marker of oxidative stress, in the follow-up acute abdomen.
Material and Method: This prospective study included 107 patients (62 men and 45 women) with a diagnosis of acute abdomen (AA). In all patients, age, gender and cause of acute abdomen were recorded. In addition, native thiol (-SH), total thiol (tSH) and disulfide (-S-S-) levels at baseline, admission and on postoperative day 3 were prospectively recorded and -SS-/-SH, -S-S-/tH and -SH/tSH ratios were calculated.
Results: When the causes of acute abdomen were assessed, it was seen that 72 patients (67.29%) underwent surgery due to appendicitis while 5 patients (4.67%) due to lower GIS perforation, 7 patients (6.54%) due to perforated peptic ulcer, 5 patients (4.67%) due to sigmoid volvulus, 4 patients (3.74%) due to strangulated hernia and 14 patients (13.08%) due to miscellaneous reasons. When thiol and disulfide levels were assessed as a single parameter, mean thiol level was 316.71±78.16 (327.5) at preoperative period and 264.00±72.85 (278.30) at postoperative period. The mean thiol level was significantly decreased at postoperative period (p<0.001). The disulfide//thiol ratio was 5.17±1.56 (5.16) at preoperative period and 5.36±2.45 (5.28) at postoperative period, indicating no significant difference (p=0.563).
Conclusions: In this study, it was found that monitoring these parameters resulting from thiol oxidation are valuable at both preoperative and postoperative period in patients with acute abdomen. Further studies are needed to optimize use of oxidative stress marker together with other established marker.

Keywords

acute abdomen, disulfide, laboratory study, thiol

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