Tiyol / Disülfit dengesinin değerlendirilmesi çocuklarda apandisitin ayırıcı tanısında yardımcı olabilir mi?

Yıl 2020, Cilt: 14 Sayı: 3, 236 - 243, 29.05.2020

Sabri Demir Yasemin Dere Günal İsmail Özmen Nermin Dindar Badem Salim Neşelioğlu Özcan Erel

https://doi.org/10.12956/tchd.627936

Öz

Öz

Amaç:
Çalışmamızın amacı, tanı konulmasında zorlanılan çocuklarda, akut apandisitin
ayırıcı tanısında, oksidatif stresin yeni bir belirteci olan tiyol/disülfit
dengesinin, kullanılabilirliğini araştırmaktır.

Gereç ve yöntemler: Çalışmaya, yaşları 0-18 yaşları aralığında bulunan kontrol grubunda
30, akut apandisit grubunda 30 olmak üzere toplam 60 gönüllü çocuk dahil
edildi. Her iki grubun da nativ tiyol, total tiyol, dinamik disülfit, dinamik
tiyol, iskemi modifiye albümin, albümin, lökosit, hemoglobin, hematokrit ve
trombosit sayıları bakıldı. Her iki grubun sonuçları SPSS (Statistical Package for Social Sciences) versiyon
17 (Chicago, USA) programı kullanılarak karşılaştırıldı. Tüm değişkenler için p
<0.05 anlamlı kabul edildi.

Bulgular:
Akut apandisit grubunda, kontrol grubu ile karşılaştırıldığında; total tiyol (p<0.001), nativ tiyol (p<0.001)
ve albümin (p<0.001) düzeyleri anlamlı
düzeyde düşük bulunmasına karşın, oksidatif tarafa kaymayı gösteren dinamik
sülfit, dinamik tiyol (p=0.003) ve iskemi
modifiye albümin (p<0.001) düzeyleri yüksek bulundu. Akut apandisit grubunda
lökosit sayısı kontrol grubuna göre daha yüksek (p <0.001) bulunurken
trombosit sayısı kontrol grubundan daha düşüktü (p = 0.03).

Tartışma:
Akut apandisitin ayırıcı tanısında, özellikle teşhis konmakta zorlanılan olgularda,
fizik muayene, görüntüleme ve güncel laboratuvar testlerinin yanı sıra, tiyol /
disülfid dengesinin değerlendirilmesi tanı koymada yardımcı olabilir. Ek olarak
albümin ve iskemi modifiye albümin düzeylerinin değerlendirilmesi testin
özgüllüğünü artırabilir. Bu test, yaşları küçük olan çocuklar ve mental retarde
hastalar gibi tanının zor konabildiği hastaların ayırıcı tanısında daha yararlı
olabilir.

Anahtar Kelimeler

Çocuk, akut apandisit, oksidatif stres, tiyol/disülfit dengesi, apendektomi

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Can thiol/disulphide homeostasis help in the differential diagnosis of appendicitis in children?

Öz

Abstract

Objective: We
aimed to investigate the potential of assessing thiol/disulfide homeostasis as
novel oxidative stress markers to improve the challenging diagnosis of acute
appendicitis in children.

Materials and Methods: A total of 60 pediatric patients (0-18 years) were enrolled in the study, 30 of which were in
the control group and 30 in the acute appendicitis group. Native thiol, total
thiol, dynamic disulfide, dynamic thiol, ischemia modified albümin,
albumin, White blood cell, hemoglobin, hematocrit, and platelet counts of both
groups were measured. The results of both
groups were compared using the SPSS (Statistical Package for Social Sciences)
version 17 (Chicago, USA) program. For all variables, p <0.05 was considered
significant.

Results: Total
thiol (p<0.001), native thiol (p<0.001), and albümin (p<0.001) levels
were significantly decreased while dynamic disulfide, dynamic thiol (p=0.003), and ischemia modified albümin (p<0.001)
levels those indicating oxidant sides were increased
in the acute appendicitis group compared to control. White blood cell counts in acute appendicitis group were higher
(p<0.001), and platelet counts were lower (p=0.03) than the control group.

Conclusion: In the differential diagnosis of acute appendicitis,
especially in cases that are difficult to diagnose, besides a physical examination, imaging, and current
laboratory tests, quantification of thiol/disulfide homeostasis may be helpful
in diagnosing. In addition, evaluating
albumin and IMA levels may increase the specificity of the test. This test can
be more helpful in case diagnosis is difficult such as children small in their
ages and mental retardation.

Anahtar Kelimeler

Children, acute appendicitis, oxidative stress, thiol/disulphide homeostasis, appendectomy

Proje Numarası

Yok

Kaynakça

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