Yemekten Sonra İçilen Sigaranın Superior Mezenterik Arter ve Portal Ven Hemodinamiğine Etkisi: Doppler Ultrasonografi Çalışması

Abstract

Amaç: Sağlıklı genç erişkinlerde, yemekten sonra içilen sigaranın mezenterik dolaşımdaki oluşturduğu değişikliklerin araştırılmasıdır. Yöntem: Çalışmaya 28 sigara içmeyen, 22 sigara içen olmak üzere toplam 50 birey katıldı. Üç gruba ayrıldı. Grup A: Sigara içmeyenler (n=28), Grup B: Sigara kullanan ve yemek sonrası da içmelerine izin verilenler (n=18), Grup C: Sigara kullanmakta olan ve yemek sonrası içmelerine izin verilmeyenler (n=16). 12 olgu hem grup B, hem de grup C’ye dahil edildi. Olgulara açlıkta Doppler sonografi yapıldı ve superior mesenterik arter (SMA) ve portal ven (PV) akım parametreleri ölçüldü. Standart bir yemek sonrasında 30, 60 ve 90. dakikalarda ölçümler tekrar edildi. Bulgular: Grup B’de SMA’in pik sistolik hız (PSH) ortalamaları hem açlık hem postprandial dönemde anlamlı olarak yüksekti (p=0,048). Gruplar arasında damar çap ortalamaları ve akım volümleri arasında sigara kullanımına göre fark yoktu (F=1,542, p=0,222; F=2,082, p=0,134). SMA’daki çap değişiklikleri her üç grupta farklı idi (F=6,406, p

Keywords

• Superior, Mezenterik arter, Portal ven, Fizyoloji, Sigara, Doppler, Ultrasonografi

References

1. 1. Moore KL. Clinically oriented Anatomy. 3nd edition. Baltimore: Williams&Wilkins, 1992;232-3.
2. 2. Failla M, Grappoilo A, Carugo S, Calchera I, Giannattasio C, Mancia G. Effects of cigarette smoking on carotid and radial artery distensibility. J Hypertens 1997;15:1659-67.
3. 3. Park SM, Shim WJ, Song WH, Lim DS, Kim YH, Ro YM. Effects of smoking on coronary blood flow velocity and coronary flow reserve assessed by transthoracic Doppler echocardiography. Echocardiography 2006;23:465-70.
4. 4. Ragueneau I, Michabud P, Demolis J-L, Moryusef A, Laillon P, FunckBrentano C. Effects of cigarette smoking on short-term variability of blood pressure in smoking and non-smoking healthy volunteers. Fundam Clin Pharmacol 1999;13:501-7.
5. 5. Unal B, Bilgili MYK, Yılmaz S, Caglayan O, Kara S. Smoking prevents the expected postprandial increase in intestinal blood flow. J Ultrasound Med 2004;23:647-53.
6. 6. Jacobovicz J, Tolazzi ARD, Timi JR. Doppler ultrasound evaluation of facial transverse and infraorbital arteries: Influence of smoking and aging process. Aesthetic Plast Surg 2007;31:526-31.
7. 7. Morita A. Tobacco smoke causes premature skin aging. J Dermatol Sci 2007;48:169-75.
8. 8. Sighinolfi MC, Mofferdin A, De Stefani S, Micali S, Cicerco AFG, Bianchi G. Immediate improvement in penile hemodynamics after cessation of smoking: Previous results. Urology 2007;69:163-5.

9. 9. Battaglia C, Battaglia M, Mancini F, et al. Cigarette smoking decreases the genital vascularization in young healthy, eumenorrheic women. J Sex Med 2011;8:1717–25. doi: 10.1111/j.1743-6109.2011.02257.x.
10. 10. Campisi R, Czernin J, Schoder H, et al. L-arginine normalizes coronary vasomotion in long term smokers. Circulation 1999;99:491-8.
11. 11. Loshbaugh JE, Loeppky JA, Grene ER. Effects of acute hypobaric hypoxia on resting and postprandial superior mesenteric artery blood flow. High Alt Med Biol 2006;7:47-53.
12. 12. Qamar MI, Read AE, Skidmore R, Evans JM, Wells PNT. Transcutaneous Doppler ultrasound measurement of superior mesenteric artery blood flow in man. Gut 1986;27:100-5.
13. 13. Sığırcı A, Baysal T, Kutlu R, Aladağ M, Saraç K, Harputluoğlu H. Doppler sonography of the inferior and superior mesenteric arteries in ulcerative colitis. J Clin Ultrasound 2001;29:130-9.
14. 14. Fisher AJ, Paulson EK, Kliewer MA, Delong DM, Nelson RC. Doppler sonography of the portal vein and hepatic artery: Measurement of a prandial effect in healty subjects. Radiology 1998;207:711-5.
15. 15. Sieber C, Beglinger C, Jaeger K , Hildebrand P, Stalder GA. Regulation of postprandial mesenteric blood flow in humans: evidence for a cholinergic nervous reflex. Gut 1991;32:361-6.
16. 16. Mathias CJ. Pharmacological manipulation of human gastrointestinal blood flow. Fundam Clin Pharmacol 1997;11:29-34.
17. 17. Morrell HE, Cohen LM, al'Absi M. Physiological and psychological symptoms and predictors in early nicotine withdrawal. Pharmacol Biochem Behav 2008;89:272-8.
18. 18. Zoli M, Merkel C, Saba C, et al. Interobserver and inter-equipment variability of echo-Doppler sonographic evaluation of the superior mesenteric artery. J Ultrasound Med 1996;15:99-106.
19. 19. Machado Jde B, Plinio Filho VM, Petersen GO, Chatkin JM. Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation. BMC Pregnancy Childbirth 2011; 11:24. doi: 10.1186/1471-2393-11-24
20. 20. Srivastava ED, Russel MAH, Feyerabend C, Rhodes J. Effect of ulcerative colitis and smoking on rectal blood flow. Gut 1990;31:1021-4.
21. 21. Suman S, Williams EJ, Thomas PW, Surgenor SL, Snook JA. Is the risk of adult coeliac disease causally related to cigarette exposure? Eur J Gastroenterol Hepatol 2003;15:995-1000.
22. 22. Austin AS, Logan RF, Thomason K, Holmes GK. Cigarette smoking and adult coeliac disease. Scand J Gastroenterol 2002;37:978-82.
23. 23. Zanten SJ. Recurrent diarrhea and weight loss associated with cessation of smoking in a patient with undiagnosed coeliac disease. Gut 2001;49:588.
24. 24. Kikuchi H, Itoh J, Fukuda S.Chronic nicotine stimulation modulates the immune response of mucosal T cells to Th1-dominant pattern via nAChR by upregulation of Th1-specific transcriptional factor. Neurosci Lett 2008;432:217-21.
25. 25. van der Heide F, Dijkstra A, Weersma RK, et al. Effects of active and passive smoking on disease course of Crohn's disease and ulcerative colitis. Inflamm Bowel Dis 2009;15:1199-207.
26. 26. Birrenbach T, Bocker U. Inflammatory bowel disease and smoking: a review of epidemiology, pathophysiology, and therapeutic implications. Inflamm Bowel Dis 2004;10:848-59.