diclemedj

Dicle Medical Journal

1300-2945 1308-9889

Dicle Üniversitesi

10.5798/dicletip.528618

Health Care Administration

Sağlık Kurumları Yönetimi

Kardiyopulmoner Baypass Sırasında Homosistein, Vitamin B12 ve Folik Asit Seviyelerinin Değişimi ve Birbirleri ile Olan İlişkilerinin İncelenmesi

https://orcid.org/0000-0003-1085-933X

Açık

Hatice Bilge

Çiğli Bölge Eğitim Hastanesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir

https://orcid.org/0000-0003-1951-8881

Göz

Mustafa

HARRAN ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0002-6652-6035

Aydın

Mehmet Salih

HARRAN ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0001-6863-1907

Padak

Mahmut

HARRAN ÜNİVERSİTESİ

https://orcid.org/0000-0001-9157-7830

Dikme

Reşat

HARRAN ÜNİVERSİTESİ

https://orcid.org/0000-0002-3047-6232

Göç

Ömer

HARRAN ÜNİVERSİTESİ

06 11 2019

46 2 369 377 02 18 2019 05 03 2019

2003

Dicle Tıp Dergisi

ÖzetAmaç: Yaptığımız bu çalışmada Kardiyopulmoner bypass (KPB)sırasında homosistein, vitamin B12 ve folik asit parametrelerinin değişimlerinebakılarak birbirleri ile olan ilişkilerinin araştırılması amaçlanmıştır.Materyal ve Metod: Göğüs Kalp Damar Cerrahisi bölümündeçeşitli sebeplerden dolayı KPB cerrahisi ile ameliyat olan hastalardan ameliyatöncesi, pompaya (kalp akciğer makinesi) giriş, kross klemp sonrası ve protaminverilmesi sonrası olmak üzere 4 jelsiz tüpe kan alınarak bir çalışma grubuoluşturuldu. Alınan kanlarda serum Vitamin B12 düzeyi ve serum Folik asitdüzeyi Kemilüminesans yöntemi ile serum Homosistein düzeyi ise Kolorimetrikyöntem ile ölçülmüştür.Bulgular: Vitamin B12, pg/MI değeri; Ameliyat öncesi206.30 ±64.76, Pompaya Giriş108.03 ± 35.75, Kross Klemp Sonrası 128.53 ± 38.43,Protamin Sonrası 141.33 ± 39.21, p<0,001 olarak bulunmuştur. Folik Asit,ng/MI değeri sırasıyla; 10.04 ± 2.89, 6.53 ± 1.84, 6.53 ± 1.95, 9.02 ± 2.83 ve p<0,001 olarak bulunmuştur.Homosistein, μmol/L değerisırasıyla;14.40 ± 4.48, 7.63 ± 2.30, 9.44 ± 2.62, 9.15 ± 2.55 ve p<0,001olarak bulunmuştur.Sonuç: Pompaya giriştehomosistein, vitamin B12 ve folik asit düzeyi prime solüsyondan dolayı sayısalolarak düşerken; pompa girişinden kross klemp sonrasına kadar homosisteindeanlamlı artış olmuş, folik asit düzeyinde artış olmamış, vitamin B12 oranındakiartış ise homosistein kadar olmamıştır. Bu durum Vitamin B12 ve Folik asitdüzeyi ile serum homosistein konsantrasyonu arasında negatif bir korelasyongöstermiştir. Kross klemp sonrasından protamin sonrasına kadarki dönemde homosisteinseviyesinde düşüş olmasına rağmen, Vitamin B12 ve folik asit seviyesindeyükselmeler olmuştur. Bu yükseklik homositeinin Vitamin B12 ve folik asit ilenegatif ilişkisine destek olmaktadır. Perfüzyon süresi uzadıkça artaninflamatuar yanıt ve kullanılan ilaçlar ile homosistein seviyesinde değişimlereneden olmuş fakat bu etkileşimlerin homosistein, Vitamin B12 ve folik asitdüzeyi ile ilişkisi istatistiksel olarak gösterilememiştir.INVESTIGATION OF THE RELATIONSHIP BETWEEN HOMOCYSTEINE, VITAMIN B12 ANDFOLIC ACID LEVELS AND THEIR RELATIONSHIP BETWEEN THE CARDIOPULMONARY BYPASSABSTRACTBackground: The aim of this study was to investigate theassociation between homocysteine, vitamin B12 and folic acid parameters incardiopulmonary bypass (CPB).Methods: In the thoracic cardiovascular surgerydepartment, a study group was formed by taking 4 gel-free scales frompre-operative, pump (heart lung machine), after cross-clamp and protamineadministration from patients who underwent surgery with CPB surgery for variousreasons. Serum vitamin B12 level and serum Folic acid level were measured bychemiluminescence method and serum homocysteine level by Colorimetric method.Results: Vitamin B12, pg / mL value; Preoperatively206.30 ± 64.76, Pump Entry 108.03 ± 35.75, Post Cross Clamp 128.53 ± 38.43,Post Protamine 141.33 ± 39.21, p <0.001. Folic Acid, ng / ml valuerespectively; 10.04 ± 2.89, 6.53 ± 1.84, 6.53 ± 1.95, 9.02 ± 2.83 and p<0.001 respectively. Homocysteine, μmol / L values were found to be 14.40 ±4.48, 7.63 ± 2.30, 9.44 ± 2.62, 9.15 ± 2.55 and p <0.001 respectively.Conclusions: While homocysteine, vitamin B12 and folicacid levels were decreased by prime solu- tion in the pump, there was asignificant increase in homocysteine from the pump inlet to the end of thecross clamp, no increase in folic acid level, and no increase in vitamin B12 ashomocysteine. This showed a negative correlation between Vitamin B12 and Folicacid level and serum homocysteine concentration. Although there was a decreasein homocysteine levels after the crosstalk after protamine, there was a rise invitamin B12 and folic acid levels. This elevation supports the negativeassociation of homocyte with Vitamin B12 and folic acid. Increased duration ofperfusion resulted in increased inflammatory response and changes inhomocysteine levels with drugs used, but these interactions were notstatistically related to homocysteine, Vitamin B12 and folic acid levels.

Kardiyopulmoner baypas Homosistein Vitamin B 12 Folik asid

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