Koroner arter bypass cerrahisi uygulanan hastalarda N -asetil sisteinin miyokardiyal reperfüzyon hasarını önlemedeki rolü
Küçük Resim Yok
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada kardiyopulmoner bypass ile koroner arter bypass cerrahisi yapılan hastalarda gelişen iskemi reperfüzyon hasarının başlangıç kardiyopleji solüsyonuna eklenen N -asetil sistein ile önlenmesi araştırıldı. Yöntem : Bu çalışma damar cerrahisi kliniğinde kardiyopulmoner bypass eşliğinde elektif koroner arter bypass cerrahisi yapılan 60 hasta (43 erkek, 17 kadın) dahil edildi. Ardışık olarak hastalar 30’u kontrol, 30’u çalışma grubu olarak ayrıldı. Çalışma grubuna kardiyopleji solüsyonuna 300 mg N -asetil sistein eklendi. Hastalardan preoperatif, postoperatif kan örnekleri alın a rak myokardiyal hasar belirteçleri (CK -MB, troponin) çalışıldı. Hastalar postoperatif inotrop ihtiyacı ve aritmi gel i şimi yönünden izlendi. Bulgular: Çalışma grubu ile kontrol grubu kıyaslandığında miyokardiyal hasar belirteçlerinden Çalışmaya alınan hastaların demografik verileri, preoperatif eşlik eden risk faktörleri, sol ventrikül ejeksiyon fraksiy o nu, hemoglobin değerleri açısından istatistiksel anlamlı farklılık yoktu. Çalışma grubu ile kontrol grubu kıyasl and ığında miyoka rdiyal hasar belirteçlerinden CK -MB düzeyleri 24. ve 48. saatlerde, troponin düzeyleri ise 6. 12. 24. ve 48. saatlerde istatistiksel olarak düşük bulundu. Postop e ratif inotropik destek ihtiyacı ve aritmi görülme sıklığı çalışma grubunda istatistiksel olarak anlamlı olmak üzere daha az bulundu. Sonuç : Kardiyopulmoner bypass eşliğinde koroner arter bypass cerrahisi yapılan hastalarda kardiyopleji solüsyo nlarına 300 mg N -asetil sistein eklenmesi ile reperfüzyon hasarı oluşumu azaltılmaktadır. M iyokardiyal korunma yöntemleri hakkında en etkin yöntemin saptanması için geniş çapta daha fazla çalışmaya ihtiyaç vardır.
Objective : In this study we researched prevention of is chemic reperfusion damage by adding N -acetyl -cystein to primary cardioplegy s olution in patients underwent coronary artery bypass surgery with cardiopulmonary bypass . Method : In this study, 60 patients(43 male, 17 female) were enrolled who were performed coronary artery bypass surgery with cardiopulmonary bypass at vascular sugery clinic. Consecutively patients divide d as 30 patients for study and 30 patients for control groups. 300 mg N -acetyl cystein added to study group’s cardioplegy solution. My ocardial damage ma rkers(CK -MB, troponin) were obtained from patients pre and postoperatively. Patients followed for postop erative inotrpe need and developing arytmia. Results : There was no statistical significance in comparison of demografic datas, preoperative accompanying risc fa ctors, left ventricule ejection fraction, hemoglobine levels of patients’ of the study. Comparing 24th and 48th hour pla sma CK -MB levels and 6th, 12th, 24th and 48th hours trop onine levels, study group’s levels were lower than control group.This difference was stastisticaly significant. Postop erative inotropic support need and incidance of aritmia was was lower in the study group, and this was statisticaly significant. Conclusion : Reperfusion damage decreases in patients who underwent coronary artery bypass surgery with cardiopu lmonary bypass by adding 300 mg N -acetyl cystein. Further research is needed for detecting most effective procedure about myocardial protection.
Objective : In this study we researched prevention of is chemic reperfusion damage by adding N -acetyl -cystein to primary cardioplegy s olution in patients underwent coronary artery bypass surgery with cardiopulmonary bypass . Method : In this study, 60 patients(43 male, 17 female) were enrolled who were performed coronary artery bypass surgery with cardiopulmonary bypass at vascular sugery clinic. Consecutively patients divide d as 30 patients for study and 30 patients for control groups. 300 mg N -acetyl cystein added to study group’s cardioplegy solution. My ocardial damage ma rkers(CK -MB, troponin) were obtained from patients pre and postoperatively. Patients followed for postop erative inotrpe need and developing arytmia. Results : There was no statistical significance in comparison of demografic datas, preoperative accompanying risc fa ctors, left ventricule ejection fraction, hemoglobine levels of patients’ of the study. Comparing 24th and 48th hour pla sma CK -MB levels and 6th, 12th, 24th and 48th hours trop onine levels, study group’s levels were lower than control group.This difference was stastisticaly significant. Postop erative inotropic support need and incidance of aritmia was was lower in the study group, and this was statisticaly significant. Conclusion : Reperfusion damage decreases in patients who underwent coronary artery bypass surgery with cardiopu lmonary bypass by adding 300 mg N -acetyl cystein. Further research is needed for detecting most effective procedure about myocardial protection.
Açıklama
Anahtar Kelimeler
Anestezi, Kalp ve Kalp Damar Sistemi, Tıbbi Araştırmalar Deneysel, Cerrahi
Kaynak
Abant Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
3
Sayı
2
