Demir eksikliği anemisi olan infantlarda beyin sapı işitsel uyarılmış potansiyel yanıtlarının değerlendirilmesi

Yıl 2024, Cilt: 17 Sayı: 4, 644 - 652, 09.10.2024

Hicran Altın , Galip Akhan Bahattin Tunç

https://doi.org/10.31362/patd.1437451

Öz

Amaç: Demir eksikliği anemisi (DEA) olan ve olmayan bebeklerin beyin fonksiyonlarını beyin sapı işitsel potansiyelleri (BAEPs) ile elektrofizyolojik olarak değerlendirmek ve karşılaştırmaktır.
Gereç ve yöntem: SDÜ Tıp Fakültesi Pediatrik Hematoloji Bilim Dalı'nda takip edilen, yaşları 6-24 aylık, 26 DEA’lı olan ve 26 DEA’lı olmayan sağlıklı çocuğa BAEP testi uygulandı. Hemoglobin (Hb) değeri yaşına göre -2SD'nin altında olan çocuklar anemik olarak kabul edildi. DEA'lı tüm hastalara aç karnına 12 hafta boyunca 3 dozda 5 mg/kg/gün iki değerlikli demir glisin sülfat kompleksi verildi. Sedasyon için testten önce kloral hidrat (50 mg/kg/doz) oral olarak verildi. BAEP, 90dB, frekans 10 Hz ve 1000-2000 klik uyaranla kaydedildi. Bu test, DEA grubuna tedaviden önce ve sonra olmak üzere iki kez, kontrol grubuna ise 3 ay arayla iki kez uygulandı.
Bulgular: DEA hastalarının 14'ünü (%53,8) erkekler, kontrol grubunun 16'sını (%61,5) kadınlar oluşturdu. DEA'lı hastaların yaş ortalaması 14,4±3,09 ay, kontrol grubu hastalarının yaş ortalaması ise 11,2±4,04 aydır. DEA'lı hastaların tedavi öncesi Hb, Hct, MCV, MCH, MCHC, transferrin satürasyon yüzdesi ve ferritin değerleri kontrol grubundan daha düşükken, trombosit ve RDW değerleri daha yüksektir (p<0,05). DEA’lı grubunun tedavi öncesi ile kontrol grubunun interpik latansları karşılaştırıldığında, DEA’lı grubun III-V interpik latansında uzama tespit
edilmiştir (p=0,002). Kontrol grubunun ve DEA’lı grubun tedavi sonrası interpik latansları karşılaştırıldığında, interpik latans değerlerinde anlamlı fark tespit edilmedi p>0,05). DEA hastaların tedavi öncesi ve tedavi sonrası I-III, III-V ve I-V interpik latans değerlerinde anlamlı fark tespit edildi (p<0,05).
Sonuç: Demir eksikliği anemisinin işitsel sistemin fonksiyonel gelişimini etkilediği görülmektedir. Tedavi edilmeyen demir eksikliği anemisi, özellikle bebeklik döneminde, merkezi işitme sistemi üzerinde uzun vadeli etkileri olabilir. Bu durum nöro-fonksiyonel yapıların maturasyonunda değişikliklere yol açabilir.

Anahtar Kelimeler

Demir eksikliği anemisi, miyelinizasyon, BAEP.

Proje Numarası

(Project date: 25.10.2002-24.04.2005, and Project number:605)

Evaluation of brainstem auditory-evoked potentials in infants with iron deficiency anemia

Öz

Purpose: To evaluate and compare the brain functions of infants with and without Iron Deficiency anaemia (IDA) electrophysiologically with brainstem auditory potentials (BAEPs).
Materials and methods: BAEP tests were performed on 26 healthy infants and 26 infants with iron deficiency anaemia, aged 6-24 months, who were followed through the Paediatric Haematology Department at SDU Faculty of Medicine. Children were classified as anaemic if their haemoglobin (Hb) level fell below -2 standard deviations for their age. All patients diagnosed with iron deficiency anaemia received 5 mg/kg/day of divalent iron glycine sulphate complex in three doses daily for a duration of 12 weeks, to be taken on an empty stomach. Both group were orally administered Chloral hydrate at a dosage of 50 mg/kg prior to the BAEP test to induce sedation. The BAEP was recorded at a sound intensity level of 90 decibels, with a frequency of 10 Hertz, and with click stimuli ranging from 1000 to 2000. The BAEP test was administered to the IDA group before and after treatment, as well as to the control group, with a 3-month interval between tests.
Results: 14 (53.8%) of the IDA patients were males, and 16 (61.5%) of the control group were females. Patients with IDA had an average age of 14.4±3.09 months, while the control group patients have an average age of 11.2±4.04 months. Patients with iron deficiency anaemia had lower pre-treatment levels of Hb, Hct, MCV, MCH, MCHC, transferrin saturation percentage, and ferritin compared to the control group, whereas platelet and RDW values were greater (p<0.05). The study compared the Brainstem Auditory Evoked Potential (BAEP) values of patients with Iron Deficiency Anaemia (IDA) before treatment with those of control patients. The results indicated that the III-V interval, showing nerve conduction time, was significantly prolonged in the pre-treatment BAEPs (p=0.002). There was no significant difference in interpeak latencies between the control group and patients with iron deficiency anaemia (IDA) following therapy (p<0.05). Significant differences were found in the I-III, III-V, and I-V interpeak latencies of individuals with iron deficiency anaemia before and after treatment (p<0.05).
Conclusion: Iron deficiency anaemia appears to affect the functional development of the auditory system. Untreated iron deficiency anaemia, especially in infancy, may have long-term effects on the central auditory system. Consequently, this can result in changes in the maturation of neuro-functional.

Anahtar Kelimeler

Iron deficiency anaemia, myelination, BAEP

Etik Beyan

The study was produced from a Licence thesis before 2020. The data in the study are from before 2020.

Destekleyen Kurum

Isparta Süleyman Demirel University Scientific Research Projects unit for financial support of this study

Proje Numarası

(Project date: 25.10.2002-24.04.2005, and Project number:605)

Teşekkür

We would like to thank Isparta Süleyman Demirel University Scientific Research Projects unit for financial support of this study.

Kaynakça

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