Akut nekrotizan pankreatit`in tanısında iskemi modifiye albuminin yeri
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Abstract
Giriú: Akut pankreatit üst karÕn akut a÷UÕlarÕQÕn önemli nedenleri arasÕndadÕr. Akutpankreatitin semptom ve bulgularÕ di÷er akut a÷UÕlar ile karÕúabilmektedir. Önemli bir iskemimarkÕUÕ olan øskemi modifiye albümin de÷erini deneysel nekrotizan pankreatit modelindeçalÕúmayÕ amaçladÕk.Metot: ÇalÕúma etik kurul onayÕ alÕnarak, 20 adet sÕçan denek kullanÕlarakgerçekleútirildi.Denekler 2 gruba ayrÕldÕ.1. Grup: Laparatomi yapÕldÕ ve hiçbir iúlem uygulanmadÕ.2. Grup: Laparatomi ile nekrotizan pankreatit oluúturuldu.%5'lik Na-Taurokolik asit kullanÕlarak oluúturulan Nekrotizan pankreatit grubu ilekontrol grubu arasÕnda karúÕlaúWÕrma yapÕldÕ. Laboratuvar de÷erlerinden Hemogram, Amilaz,Albumin, Kalsiyum, Kreatinin Kinaz, Troponin-I, Oksijen basÕncÕ ve øskemi ModifiyeAlbümin e bakÕldÕ. Histopatolojik incelemede pankreas dokusunda ödem, asiner nekroz,inflamatuvar hücre infiltrasyonu, hemoraji, ya÷ nekrozu ve perivasküler inflamasyonaraúWÕUÕldÕ. Bulunan de÷erler istatistiksel olarak karúÕlaúWÕUÕldÕ.Bulgular: Grup 1 ile grup 2 arasÕnda albümin, kalsiyum, kreatinin kinaz, troponin-Ive Hemogram arasÕnda fark bulunmadÕ (P>0.05). øskemi modifiye albümin, oksijen basÕncÕ veamilaz de÷eri arasÕnda anlamlÕ bir fark tespit edildi (P<0.001). Histopatolojikde÷erlendirmede grup 2'nin tüm deneklerinde nekrotizan pankreatit bulgusu saptandÕ.Sonuç: Bu deneysel çalÕúmada øskemi modifiye albümin'Õn akut pankreatit tanÕVÕndaönemli ve de÷erli bir tanÕ markÕUÕ olabilece÷i görülmektedir. Introduction: Acute pancreatitis is among the important causes of acute upperabdominal pain. The symptoms and findings of acute pancreatitis cannot be differentiatedfrom other acute abdominal pains. We planned to test ischemia-modified albumin level in thediagnosis of necrotizing pancreatitis, in an experimental study.Method: The study was conducted with 20 experimental animals(rat) following theconsent of the board of ethics.The experimental animals were categorized into 2 groups.Group I: Had laparotomy and no further procedures.Group II: Had laparotomy and necrotizing pancreatitis was performed.The necrotizing pancreatitis group, which was formed by using 5% Na-Taurocholicacid, was compared to the control group. Hemogram, amylase, albumin, calcium, creatininekinase, troponin-I, oxygen pressure, and ischemia-modified albumin levels were detected.Histopathological evaluation included edema, acinar necrosis, inflammatory cell infiltration,hemorrhage, fat necrosis, and perivascular inflammation in the pancreatic tissue. The resultswere compared statistically.Results: No differences were found between Group I and II regarding albumin,calcium, creatinine kinase, troponin-I, and hemogram (P>0.05). There was a statisticallysignificant difference regarding ischemia-modified albumin, oxygen pressure, and amylasevalues (P<0.001). The histopathological evaluation revealed that all the experimental animalsin Group II had necrotizing pancreatitis findings.Conclusion: This experimental study shows that ischemia-modified albumin can bea significant and valuable diagnostic marker in the diagnosis of acute pancreatitis
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