Akut mesenterik iskeminin erken dönemlerinde ortalama platelet hacmi ve iskemi modifiye albümin düzeylerinin rolü: bir deneysel çalışma

Yıl 2019, Cilt: 44 Sayı: 1, 154 - 159, 31.03.2019

Güvenç Cantilav Tuna Bilecik Nurullah Bülbüller

https://doi.org/10.17826/cumj.453571

Öz

Amaç: Bu çalışmanın amacı akut mezenterik sikeminin (AMİ) erken tanısında ortalama trombosit hacminin (MPV) ve iskemi modifiye albümin (IMA) dğzeylerinin rolünü belirlemekti.

Gereç ve Yöntem: Bu çalışmada, 18 Wistar Albino cinsi sıçan, her grupta 6 sıçan olacak şekilde 3 deney grubuna rasgele olarak ayrıldı; laparotomisiz şam grubu, laparotomi yapılan control grubu ve mezenterik iskemi grubu. Trombosit sayısı, MPV ve IMA, AMI grubunda 120. dk.lık superior mezenterik arter tıkanıklığının sonunda ve aynı zamanda diğer gruplarda çalışıldı.

Bulgular: AMI grubunda MPV ve IMA değerleri diğer 2 gruba göre anlamlı derecede yüksekti; trombosit sayısı anlamlı olarak düşüktü. Kontrol ve şam grupları arasında bu parametreler açısından istatistiksel olarak anlamlı bir fark yoktu.

Sonuç: AMI hızlı tanı konulmazsa oldukça mortal olabilen bir hastalıktır. Bu nedenle erken tanıda bu parametrelerin rolünü tanımlamak için daha fazla klinik çalışma gereklidir.

Anahtar Kelimeler

Akut mezenter iskemi, Ortalama trombosit hacmi, İskemi modifiye albumin

The role of mean platelet volume and ischemia modified albumin levels in early periods of acute mesenteric ischemia: an experimental study

Öz

The aim of this study was to determine the role of mean platelet volume (MPV) and ischemia modified albumin (IMA) in early diagnosis of acute mesenteric ischemia (AMI).

Materials and Methods: In this study, 18 Wistar Albino rats were randomly assigned to 3 experimental groups with 6 rats in each group as; sham group without laparotomy, control group with laparotomy and mesenteric ischemia-induced group. Platelet count, MPV and IMA were studied at the end of the 120th min of superior mesenteric artery obstruction in AMI group and at the same time in other groups.  

Results: In AMI group MPV and IMA values were significantly higher compared with other 2 groups, while platelet count was significantly lower . There was not any statistically significant difference between control and sham groups regarding these parameters. 

Conclusion: Further clinical studies are required to define the role of these parameters in early diagnosis of AMI since AMI is a highly mortal disease if not diagnosed promptly

Anahtar Kelimeler

Acute mesenteric ischemia, mean platelet volume, ischemia modified albumin

Kaynakça

• 1. Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, Ben-Ishay O, Rubinstein C, Balogh ZJ, Civil I, Coccolini F, Leppaniemi A, Peitzman A, Ansaloni L, Sugrue M, Sartelli M, Di Saverio S, Fraga GP, Catena F. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery.World J Emerg Surg. 2017 Aug 7;12:38.
• 2. Resch TA, Acosta S, and Sonesson B. Endovascular techniques in acute arterial mesenteric ischemia.Semin Vasc Surg. 2010 Mar;23(1):29-35.
• 3. Kassahun WT, Schulz T, Richter O, and Hauss, J. Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review. Langenbecks Arch Surg. 2008 Mar;393(2):163-71.
• 4. Acosta S. Mesenteric ischemia.Curr Opin Crit Care. 2015 Apr;21(2):171-8.
• 5. Kim HK, Hwang D, Park S, Huh S, Lee JM, Yun WS, Kim YW . Effect of Clinical Suspicion by Referral Physician and Early Outcomes in Patients with Acute Superior Mesenteric Artery Embolism. Vasc Specialist Int. 2017 Sep;33(3):99-107.
• 6. Ierardi AM, Tsetis D, Sbaraini S, Angileri SA, Galanakis N, Petrillo M, Patella F, Panella S, Balestra F, Lucchina N, Carrafiello G. The role of endovascular therapy in acute mesenteric ischemia. Ann Gastroenterol. 2017;30(5):526-533.
• 7. Kirkpatrick ID, Kroeker MA, Greenberg HM. Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology. 2003 Oct;229(1):91-8.
• 8. Lehtimäki TT, Kärkkäinen JM, Saari P, Manninen H, Paajanen H, Vanninen R. Detecting acute mesenteric ischemia in CT of the acute abdomen is dependent on clinical suspicion: Review of 95 consecutive patients. Eur J Radiol. 2015 Dec;84(12):2444-53.
• 9. Evennett NJ, Petrov MS, Mittal A, Windsor JA. Systematic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia. World J Surg. 2009 Jul;33(7):1374-83.
• 10. Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The diagnosis of acute mesenteric ischemia: A systematic review and meta-analysis. Acad Emerg Med. 2013 Nov;20(11):1087-100.
• 11. Mezouar S, Frere C, Darbousset R, Mege D, Crescence L, Dignat-George F, Panicot-Dubois L, Dubois C. Role of platelets in cancer and cancer-associated thrombosis: Experimental and clinical evidences.Thromb Res. 2016 Mar;139:65-76.
• 12. Riedl J, Kaider A, Reitter EM, Marosi C, Jäger U, Schwarzinger I, Zielinski C, Pabinger I, Ay C. Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. Results from the Vienna Cancer and Thrombosis Study (CATS).Thromb Haemost. 2014 Apr 1;111(4):670-8.
• 13. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med. 2000 Nov; 19(4):311-5.
• 14. Sbarouni E, Georgiadou P, Voudris V. Ischemia modified albumin changes - review and clinical implications. Clin Chem Lab Med. 2011 Feb;49(2):177-84.
• 15. Mishra B, Pandey S, Niraula SR, Rai BK, Karki P, Baral N, Lamsal M . Utility of Ischemia Modified Albumin as an Early Marker for Diagnosis of Acute Coronary Syndrome.J Nepal Health Res Counc. 2018 Mar 13;16(1):16-21.
• 16. Ghosh K, Muddeshwar MG, Ghosh K. Ischemia Modified AlbuminTest to Detect Early Diabetic Complications. Am J Med Sci. 2017 Nov;354(5):467-470.
• 17. Park WM, Gloviczki P, Cherry KJ, Hallett JW, Bower TC, Panneton JM, Schleck C, Ilstrup D, Harmsen WS, Noel AA. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg. 2002; 35: 445–452.
• 18. Arthurs ZM, Titus J, Bannazadeh M, Eagleton MJ, Srivastava S, Sarac TP, Clair DG. A comparison of endovascular revascularization with traditional therapy for the treatment of acute mesenteric ischemia. J Vasc Surg. 2011 Mar;53(3):698-704; discussion 704-5.
• 19. Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH 3rd. Comparison of open and endovascular treatment of acute mesenteric ischemia. J Vasc Surg. 2014 Jan;59(1):159-64.
• 20. Aktekin A, Emir S, Sağlam A. Factors affecting mortality in acute mesenteric obstruction. Ulus Travma Acil Cerrahi Derg. 2009 May; 15(3):217-21.
• 21. Türkoğlu A, Gül M, Oğuz A, Bozdağ Z, Ülger BV, Yılmaz A, Aldemir M . Mean platelet volume: is it a predictive parameter in diagnosis of acute mesenteric ischemia? Int Surg. 2015 May;100(5):962-5.
• 22. Degerli V, Ergin I, Duran FY, Ustuner MA, Duran O. Could Mean Platelet Volume Be a Reliable Indicator for Acute Mesenteric Ischemia Diagnosis? A Case-Control Study. Biomed Res Int. 2016;2016:9810280.
• 23. Wang Z, Chen JQ, Liu JL, Tian L. A Novel Scoring System for Diagnosing Acute Mesenteric Ischemia in the Emergency Ward. World J Surg. 2017 Aug;41(8):1966-1974.
• 24. Altintoprak F, Arslan Y, Yalkin O, Uzunoglu Y, Ozkan OV. Mean platelet volumeas a potential prognostic marker in patients with acute mesenteric ischemia-retrospective study.World J Emerg Surg. 2013 Nov 25;8(1):49.
• 25. Bilgiç İC, Gelecek S, Ozmen MM, Kasapoglu B. The association of elevated mean platelet volume with the outcome of acute mesenteric ischemia. Blood Coagul Fibrinolysis. 2015 Oct;26(7):727-30.
• 26.Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochem Med (Zagreb). 2016;26(2):178-93.
• 27. Zhang S, Cui YL, Diao MY, Chen DC, Lin ZF. Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically Ill Patients. Chin Med J (Engl). 2015 Aug 5; 128(15):2012-8.
• 28. Toptas M, Akkoc İ, Savas Y, Uzman S, Toptas Y, Can MM. Novel hematologic inflammatory parameters to predict acute mesenteric ischemia.Blood Coagul Fibrinolysis. 2016 Mar;27(2):127-30.
• 29. Gunduz A,Turedi S,Mentese A,Karahan SC,Hos G,Tatli O,et al.Ischemia-modified albumin in the diagnosis of acute mesenteric ischemia: a preliminary study. Am J Emerg Med.2008 Feb;26(2):202-5.
• 30. Gunduz A,Turkmen S,Turedi S,Mentese A,Yulug E,Ulusoy H, Karahan SC, Topbas M. Time-dependent variations inischemia-modified albumin levels in mesenteric ischemia. Acad Emerg Med. 2009 Jun;16(6):539-43.
• 31. Dundar ZD,Cander B,Gul M,Karabulut KU,Girisgin S. Serum ischemia-modified albumin levels in an experimental acute mesenteric ischemia model. Acad Emerg Med. 2010 Nov;17(11):1233-8.
• 32. Kadioğlu H, Ömür D, Bozkurt S, Ferlengez E, Memmı N,Ersoy YE, Çıpe G. Ischemia modified albumin can predict necrosis at incarcerated hernias. Dis Markers.2013;35(6):807-10.
• 33. Treskes N,Persoon AM,van Zanten ARH. Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis. Intern Emerg Med. 2017 Sep;12(6):821-836.
• 34. Uygun M,Yilmaz S,Pekdemir M,Duman C,Gürbüz YS. The diagnostic value of ischemia-modified albumin in a rat model of acute mesenteric ischemia. Acad Emerg Med. 2011 Apr;18(4):355-9.
• 35. Zhang FX,Ma BB,Liang GZ,Zhang H. Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia. Mol Med Rep.2011 Nov-Dec;4(6):1095-9.
• 36. Huang HH, Chang YC, Yen DH, Kao WF, Chen JD, Wang LM, Huang CI, Lee CH. Clinical factors and outcomes in patients with acute mesenteric ischemia in the emergency department.J Chin Med Assoc. 2005 Jul;68(7):299-306.