Koroner Bypass Uygulanan Diyabetik Hastalarda Endotel Koruma Solüsyonunun Safen Ven Endotelinde Oksidatif Stres Üzerine Etkilerinin İncelenmesi

Öz

Amaç: Diyabetik koroner arter hastalarının baypaslarında kullanılan safen ven greftleri normal hasta popülasyonundan daha erken tıkanır. Bu çalışmada, diyabetik hastalarda operasyon sırasında alınan safen ven greftlerinin oksidatif hasara karşı korunmasında endotel koruma solüsyonunun etkileri araştırıldı.

Gereç ve Yöntem: Hastanemizde 2021-2022 yılları arasında koroner bypass ameliyatı olan 50 diyabet hastasının operasyonu sırasında alınan safen ven greftlerinin kalan kısımları üç parçaya bölündü. Her parça salin (grup 1), heparinize otolog kan (grup 2) ve endotel koruma solüsyonu (grup 3) olmak üzere farklı bir solüsyona yerleştirildi. Çözeltilerde 4 saat bekletildikten sonra hücresel ve DNA oksidatif stres belirteçleri araştırıldı.

Bulgular: Toplam antioksidan kapasite (TAC) açısından gruplar arasında anlamlı fark yoktu (p>0.05). Toplam oksidatif durum (TOS) seviyeleri, endotel solüsyonu olmayan grup 1 ve 2'de (1,57±0,46'ya karşı 1,55±0,19) grup 3'ten (1,31±0,11) anlamlı olarak yüksekti (p<0,05). Ayrıca oksidatif stres indeksi (OSI) grup 3'te anlamlı olarak daha düşüktü (p<0.05). Öte yandan nükleer oksidatif stresi gösteren 8-hidroksi-2'-deoksiguanozin (8-OHdG) düzeyleri de grup 3'te düşük bulundu (p<0.05).

Sonuç: Sonuçlarımız diyabetik hastalarda kullanılan safen ven greftlerinde endotel solüsyonu kullanımının oksidatif hasarı önlediğini desteklemektedir.

Anahtar Kelimeler

• Diyabetik koroner arter hastalığı
• safen greft
• oksidatif stres
• endotel koruma solüsyonu

Investigation of the Effects of Endothelial Protection Solution on Oxidative Stress in Saphenous Vein Endothelium in Diabetic Patients undergoing Coronary Bypass

Öz

Objective: Saphenous vein grafts used for bypasses of diabetic coronary artery patients are occluded earlier than the normal patient population. In this study, the effects of endothelial protection solution on the protection of saphenous vein grafts taken during the operation against oxidative damage in diabetic patients were investigated.

Materials & Methods: The remaining parts of the saphenous vein grafts removed during the operation of 50 diabetic patients who underwent coronary bypass operation in our hospital between 2021 and 2022 were divided into three pieces. Each piece was placed into a different solution as saline (group 1), heparinized autologous blood (group 2), and endothelial protection solution (group 3). They were kept in solutions for 4 hours and then cellular and DNA oxidative stress markers were investigated.

Results: There was no significant difference between the groups in terms of total antioxidant capacity (TAC) (p>0.05). Total oxidative status (TOS) levels in groups 1 and 2 without endothelial solution (1.57±0.46 vs. 1.55±0.19) were significantly higher than those in group 3 (1.31±0.11) (p<0.05). Moreover, the oxidative stress index (OSI) was significantly lower in group 3 (p<0.05). On the other hand, 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels, which indicate nuclear oxidative stress, were also found to be low in group 3 (p<0.05).

Conclusion: Our results support that the use of endothelial solution on saphenous vein grafts used in diabetic patients prevents oxidative damage.

Anahtar Kelimeler

• Diabetic coronary artery disease
• saphenous graft
• oxidative stress
• endothelial protection solution

Kaynakça

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