Adenotonsillektomi ve Adenoidektominin Mean Platelet Volüm (MPV) düzeyleri üzerine etkisi

Yıl 2016, Cilt: 6 Sayı: 2, 76 - 80, 19.10.2016

Serhan Derin , Murat Şahan , Hatice Topal Yaşar Topal

https://doi.org/10.16899/ctd.77472

Öz

Amaç: Adenotonsiller hipertrofiler (ATH) kardiyopulmoner hastalıklar başta olmak üzere bir çok hastalığa neden olmaktadır. Daha önceki çalışmalar ATH li hastalarda pulmoner arter hipertansiyon insidansının arttığını ve adenotonsillektomi ile gerilediğini raporlamışlardır. Mean platelet volüm (MPV) son çalışmalarda bir çok kardiyak hastalıkta olduğu gibi pulmoner hipertansiyonda da prognostik kriter olma yolundadır. Büyük trombositler daha fazla proinflamatuar, protrombotik ve vazomotor aktiviteye sahiptir. Bu çalışmanın amacı adenotonsillektomi ve adenoidektomi operasyonu sonrası MPV değişimleri olup olmadığını  araştırmaktır. 

Hastalar ve Metod: Bu çalışmada ATH de MPV değerleri ölçüldü ve cerrahi tedavilerin MPV değerleri üserine etkisi araştırıldı. Otuz beş hastaya adenotonsillektomi, 30 hastaya adenoidektomi yapıldı. Preoperatif ve postoperatif 3. ay hemogram sonuçları karşılaştırıldı.  

Bulgular: Hastaların ortalama yaşı 6.51 ± 2.75 (2-16)’tı. Operasyon sonrası MPV değerlerindeki düşüş istatistiksel olarak anlamlıydı. (Preoperatif 9,75±0,95; Postoperatif 8,14±1,25). p<0,005

Sonuç: Adenotonsillektomi ve adenoidektomi operasyonları kardiyopulmoner komplikasyon belirteci olan MPV değerlerini etkili şekilde düşürmektedir. 

Anahtar Kelimeler

Mean platelet volüm(MPV), Adenotonsiller hipertrofi, Adenotonsillektomi, Adenoidektomi.

Impact of Adenotonsillectomy and Adenoidectomy on Mean Platelet Volume (MPV) Levels

Öz

-Adenotonsillar hypertrophy (ATH) leads to many disorders, especially cardiopulmonary diseases. Previous studies have reported the increase in pulmonary hypertension incidence in patients with ATH, as well as a decrease after adenotonsillectomy. Mean platelet volume (MPV) is becoming a prognostic indicator for pulmonary hypertension in recent studies, as it is in most cardiac diseases. It is known that larger platelets have increased proinflammatory and vasomotor activity, and prothrombotic potential. The purpose of this study to investigate whether of MPV levels changes after adenotonsillectomy and adenoidectomy.Methods- In this study, MPV values in patients with ATH were evaluated, and the impact of surgical treatment on MPV levels was analyzed. Thirty-five patients had adenotonsillectomy, while the remaining 30 patients had adenoidectomy. The preoperative and postoperative third month hemogram results were compared. Results- The mean age of the children was 6.51 ± 2.75 (2-16) years. The decrease in MPV levels after the operation was statistically significant (Preoperative 9,75±0,95

Anahtar Kelimeler

Mean platelet volume (MPV); Adenotonsillar hypertrophy; Adenotonsillectomy; Adenoidectomy.

Kaynakça

• Tarlipinar A, Duman D, Uslu C, Egeli E. The effects of obstructive sleep apne syndrome dueto adenotonsil- lar hypertrophy on the cardiovascular system in chil- dren. Turk Journal of Pediatr 2011;53:359-63.
• Abdel-Aziz M. Asymptomatic cardiopulmonary chang- es caused by adenoid hypertrophy. J Craniofac Surg 2011;22:1401-3.
• Yilmaz MD, Onrat E, AltuntasA, et al. The effects of ton- sillectomy and adenoidectomy on pulmonary arterial pressure in children. Am J Otolaryngol 2005;26:18-21.
• Kucur C, Kulekci S, Zorlu A, Savran B, Oghan F, Yildi- rim N. Mean platelet volume levels in children with adenoid hypertrophy. J Craniofac Surg 2014;25:29-31.
• Ugur MB, Dogan SM, et al. Effect of adenoidectomy and/or tonsillectomy on cardiac functions in children with obstructive sleep apnea. Orl J Otorhinolaryngol 2008;70:202-8.
• Abd El-Moneim ES, Badawy BS, Atya M. The effect of adenoidectomy on right ventricular performance in children. Int J Pediatr Otorhinolaryngol 2009;73:1584- 8
• Koc S, Aytekin M, Kalay N, et al. The effect of adenoton- sillectomy on right ventricle function and pulmonary artery pressure in children with adenotonsillar hyper- trophy. Int J Pediatr Otorhinolaryngol 2012;76:45-8.
• Varol E, Uysal BA, Ozaydin M. Platelet Indices in Pa- tients With Pulmonary Arterial Hypertension. Clin Appl Thromb Hemost 2011;17:171-4.
• Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: Methodological is- sues. Platelets 2002;13:301-6.
• Brodsky L. Modern assessment of tonsils and ade- noids. Pediatr Clin North Am 1989;36:1551-69.
• Guilleminault C, Korobkin R, Winkle R. A review of 50 children with obstructive sleep apnea syndrome. Lung 1981;159:275-87.
• Pac A, Karadag A, Kurtaran H, Aktas D. Comparison of cardiac function and valvular damage in children with and without adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2005;69:527-32.
• Naiboglu B, Deveci S, Duman D, et al. Effect of upper airway obstruction on pulmonary arterial pressure in children. Int J Pediatr Otorhinolaryngol 2008:72;1425- 9.
• Miman MC, Kirazli T, Ozyurek R. Doppler echocardi- ography in adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2000;54:21-6.
• Görür K, Döven O, Unal M, Akkuş N, Ozcan C. Preope- rative and postoperative cardiac and clinical findings of patients with adenotonsillar hypertrophy. Int J Pe- diatr Otorhinolaryngol 2001;59:41-6.
• Can MM, Tanboğa IH, Demircan HC, et al. Enhanced hemostatic indices in patients with pulmonary arteri- al hypertension: an observational study. Thromb Res 2010;126:280-2.
• Nakonechnicov S, Gabbasov Z, Chazova I, Popov E, Belenkov Yu. Platelet aggregation in patients with primary pulmonary hypertension. Blood Coagul Fibri- nolysis 1996;7:225-7.
• Kanbay A, Tutar N, Kaya E, et al. Mean platelet volu- me in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases. Blo- od Coagul Fibrinolysis 2013;24:532-6.
• Thompson CB, Jacubowski JA, Quinn PG, Deykin D, Va- leri CR. Platelet size is a determinant of platelet func- tion. J Lab Clin Med 1983;101:205-13.
• Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibri- nolysis 1996;7:157-61.
• Kilciler G, Genc H, Tapan S, et al. Mean platelet volu- me and its relationship with carotid atherosclerosis in subjects with non-alcoholic fatty liver disease. Ups J Med Sci 2010;115:253-9.
• Lopes AA, Maeda NY, Almeida A, Jaeger R, Ebaid M, Chamone DF. Circulating platelet aggregates indicati- ve of in vivo platelet activation in pulmonary hyper- tension. Angiology 1993;44:701-6.
• Attia G, Ahmad MA, Saleh AB, Elsharkawy A. Impact of obstructive sleep apnea on global myocardial perfor- mance in children assessed by tissue Doppler imaging. Pediatr Cardiol. 2010;31:1025-36.
• Onder S, Caypinar B, Yilmaz AS, Toros SZ, Oysu C. Rela- tion of mean platelet volume with obstructive adeno- id hypertrophy in children. Int J Pediatr Otorhinolary- ngol. 2014 78:1449-51.
• Cengiz C, Erhan Y, Murat T et al. Values of mean plate- let volume in patients with chronic tonsillitis and ade- noid hypertrophy. Pak J Med Sci 2013;29(2):569-72.