The Role And Value Of Oxidatıve Stress In The Diagnosis And Pathogenesis Of Stemı Patients

Year 2012, Volume: 6 Issue: 1, 1 - 7, 22.04.2012

Asliddin Ahmedali

Abstract

The Role And Value Of Oxidatıve Stress In The Diagnosis And Pathogenesis Of Stemı Patients

Abstract

Amaç: Akut ST elevasyonlu miyokard infarktüste (STEMİ) diğer tanısal belirteçlerin yanısıra oksidatif stress parametrelerinin nasıl etkilendiğini araştırarak, oksidatif stres parametrelerinin akut STEMİ hastalarında kullanılabilirliğini tartışmak istedik.
Materyal ve Metod: EKG ve kardiyak enzim sonuçları ile STEMİ tanısı doğrulanan 31 hasta retrospektif olarak çalışmaya dahil edilmiştir. 35 sağlıklı gönüllü kontrol grubu olarak alınmıştır.

Acil servise başvuru anında, oksidatif stres parametrelerini ölçmek için periferal venöz kan örneği alındı. Serum antioksidan durumu, STEMİ hastaları ve sağlıklı gönüllülerde total
antioksidan durum (TAS) ve tiyol (T-SH) düzeyi ölçülerek, serum oksidatif durumu total oksidatif durum (TOS) ölçülerek değerlendirildi ve ardından oksidatif stres indeksi (OSI) hesaplandı.

Bulgular: Hastaların 29’u (%93.5)erkek, 2’si (%6.5) kadındı. Yaş ortalaması 54.90 ± 12.23 yıldı. Kontrol grubu ile karşılaştırıldığında TOS, TAS ve OSI düzeyleri hasta grubunda yüksekti ve bu sonuçlar istatistiksel olarak anlamlı olup; sırasıyla, 15.02±10.82 μmol H2O2equivalent/l vs. 8.13±2.71 μmol H2O2 equivalent/l, p=0.001; 2310.95±549.80 μmol Trolox equivalent/l vs. 2065.71±280.98 μmol Trolox equivalent/l p=0.031; 0.65±0.40 arbitrary unit vs. 0.39±0.10 arbitrary unit, p=0.001). Ayrıca T-SH düzeyi hasta grubunda kontrol grubuna göre düşüktü (sırasıyla, 282.00±183.91 µmol/l . 472.11±307.15 µmol/l p=0.013).
Sonuç: Bu çalışmada STEMİ hastalarında T-SH düzeyleri, TOS ve OSI düzeylerinde değişiklikler olması, patogenezde oksidatif stresin rol aldığını düşündürmektedir.
Bu testlerin, tanıda, mevcut testlerin yanısıra yol gösterebileceği ileri sürülebilir. Ancak daha kapsamlı ve iyi dizayn edilmiş ileri çalışmalara ihtiyaç vardır.

ABSRACT
Objective: The objective of the study was to evaluate the usage of oxidative stress parameters in acute ST-elevation myocardial infarction (STEMI) beside other diagnostic markers, by determination of how oxidative stress parameters were affected.

Materials and Methods: A total of 31 consecutive patients with STEMI were diagnosed
by electrocardiography and cardiac enzyme results were included in the study. Thirty five volunteers were included as the control group. On admission to the emergency department,
peripheral venous blood sample was taken for measuring oxidative stress parameters. Serum antioxidative status was evaluated by measuring Total Antioxidant Status (TAS)
and Thiol (T-SH) levels in patients with ST-elevation myocardial infarction and in healthy individuals. Serum oxidative status was evaluated by measuring Total Oxidant Status (TOS),
then Oxidative Stress Index (OSI) was calculated.

Results: The male/female ratio of the patients was 29/2. Mean age was 54.90±12.23 years. TOS, TAS and OSI levels increased in the patient group compared to the control group (respectively, 15.02±10.82 μmol H2O2 equivalent/l vs. 8.13±2.71 μmol H2O2 equivalent/l, p=0.001; 2310.95±549.80 μmol Trolox equivalent/l vs. 2065.71±280.98 μmol Trolox equivalent/l p=0.031; 0.65±0.40 arbitrary unit vs. 0.39±0.10 arbitrary unit, p=0.001). On the other hand; T-SH level was decreased in the patient group compared to the control group
(respectively, 282.00±183.91 µmol/l vs. 472.11±307.15 µmol/l p=0.013).

Conclusion: Altered levels of T-SH as an antioxidant and also increased levels of TOS and OSI at STEMI patients may give an idea about the role of oxidative stress at the pathogenesis of STEMI , thus; usage of oxidative stress tests cooperative with the existing tests may be approved, but more comprehensive and well-designed studies are demanded.

Keywords

Oksidatif stress, ST yükseklikli myokard infarktüsü, total oksidan durum, total antioksidan durum, tiyol (TS-H)

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