Güvenç CANTİLAV, Tuna BİLECİK, Nurullah BÜLBÜLLER

Akut mesenterik iskeminin erken dönemlerinde ortalama platelet hacmi ve iskemi modifiye albümin düzeylerinin rolü: bir deneysel çalışma

Amaç: Bu çalışmanın amacı akut mezenterik sikeminin (AMİ) erken tanısında ortalama trombosit hacminin (MPV) ve iskemi modifiye albümin (IMA) dğzeylerinin rolünü belirlemekti.Gereç ve Yöntem: Bu çalışmada, 18 Wistar Albino cinsi sıçan, her grupta 6 sıçan olacak şekilde 3 deney grubuna rasgele olarak ayrıldı; laparotomisiz şam grubu, laparotomi yapılan control grubu ve mezenterik iskemi grubu. Trombosit sayısı, MPV ve IMA, AMI grubunda 120. dk.lık superior mezenterik arter tıkanıklığının sonunda ve aynı zamanda diğer gruplarda çalışıldı.Bulgular: AMI grubunda MPV ve IMA değerleri diğer 2 gruba göre anlamlı derecede yüksekti; trombosit sayısı anlamlı olarak düşüktü. Kontrol ve şam grupları arasında bu parametreler açısından istatistiksel olarak anlamlı bir fark yoktu.Sonuç: AMI hızlı tanı konulmazsa oldukça mortal olabilen bir hastalıktır. Bu nedenle erken tanıda bu parametrelerin rolünü tanımlamak için daha fazla klinik çalışma gereklidir.

Anahtar Kelimeler:

Akut mezenter iskemi, Ortalama trombosit hacmi, İskemi modifiye albumin

The role of mean platelet volume and ischemia modified albumin levels in early periods of acute mesenteric ischemia: an experimental study

The aim of this study was to determine the role of mean platelet volume (MPV) and ischemia modified albumin (IMA) in early diagnosis of acute mesenteric ischemia (AMI).Materials and Methods: In this study, 18 Wistar Albino rats were randomly assigned to 3 experimental groups with 6 rats in each group as; sham group without laparotomy, control group with laparotomy and mesenteric ischemia-induced group. Platelet count, MPV and IMA were studied at the end of the 120th min of superior mesenteric artery obstruction in AMI group and at the same time in other groups. Results: In AMI group MPV and IMA values were significantly higher compared with other 2 groups, while platelet count was significantly lower . There was not any statistically significant difference between control and sham groups regarding these parameters. Conclusion: Further clinical studies are required to define the role of these parameters in early diagnosis of AMI since AMI is a highly mortal disease if not diagnosed promptly

Keywords:

Acute mesenteric ischemia, mean platelet volume, ischemia modified albumin,

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1. Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, Ben-Ishay O et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery.World J Emerg Surg. 2017;7;12:38.
2. Resch TA, Acosta S, and Sonesson B. Endovascular techniques in acute arterial mesenteric ischemia. Semin Vasc Surg. 2010;23:29-35.
3. Kassahun WT, Schulz T, Richter O, Hauss J. Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review. Langenbecks Arch Surg. 2008;393:163-71.
4. Acosta S. Mesenteric ischemia.Curr Opin Crit Care. 2015;21:171-8.
5. Kim HK, Hwang D, Park S, Huh S, Lee JM, Yun WS et al. Effect of clinical suspicion by referral physician and early outcomes in patients with acute superior mesenteric artery embolism. Vasc Specialist Int. 2017;33:99-107.
6. Ierardi AM, Tsetis D, Sbaraini S, Angileri SA, Galanakis N, Petrillo M et al. The role of endovascular therapy in acute mesenteric ischemia. Ann Gastroenterol. 2017;30:526-33.
7. Kirkpatrick ID, Kroeker MA, Greenberg HM. Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology. 2003;229:91-8.
8. Lehtimäki TT, Kärkkäinen JM, Saari P, Manninen H, Paajanen H, Vanninen R. Detecting acute mesenteric ischemia in CT of the acute abdomen is dependent on clinical suspicion: Review of 95 consecutive patients. Eur J Radiol. 2015;84:2444-53.
9. Evennett NJ, Petrov MS, Mittal A, Windsor JA. Systematic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia. World J Surg. 2009;33:1374-83.
10. Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The diagnosis of acute mesenteric ischemia: A systematic review and meta-analysis. Acad Emerg Med. 2013;20:1087-100.
11. Mezouar S, Frere C, Darbousset R, Mege D, Crescence L, Dignat-George F et al. Role of platelets in cancer and cancer-associated thrombosis: Experimental and clinical evidences. Thromb Res. 2016;139:65-76.
12. Riedl J, Kaider A, Reitter EM, Marosi C, Jäger U, Schwarzinger I, et al. Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. Results from the Vienna Cancer and Thrombosis Study (CATS). Thromb Haemost. 2014;111:670-8.
13. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med. 2000;19:311-5.
14. Sbarouni E, Georgiadou P, Voudris V. Ischemia modified albumin changes - review and clinical implications. Clin Chem Lab Med. 2011;49:177-84.
15. Mishra B, Pandey S, Niraula SR, Rai BK, Karki P, Baral N et al . Utility of ischemia modified albumin as an early marker for diagnosis of acute coronary syndrome. J Nepal Health Res Counc. 2018;16:16-21.
16. Ghosh K, Muddeshwar MG, Ghosh K. Ischemia modified albumintest to detect early diabetic complications. Am J Med Sci. 2017;354:467-70.
17. Park WM, Gloviczki P, Cherry KJ, Hallett JW, Bower TC, Panneton JM et al. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg. 2002;35:445-52.
18. Arthurs ZM, Titus J, Bannazadeh M, Eagleton MJ, Srivastava S, Sarac TP et al. A comparison of endovascular revascularization with traditional therapy for the treatment of acute mesenteric ischemia. J Vasc Surg. 2011;53:698-704.
19. Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH 3rd. Comparison of open and endovascular treatment of acute mesenteric ischemia. J Vasc Surg. 2014;59:159-64.
20. Aktekin A, Emir S, Sağlam A. Factors affecting mortality in acute mesenteric obstruction. Ulus Travma Acil Cerrahi Derg. 2009;15:217-21.
21. Türkoğlu A, Gül M, Oğuz A, Bozdağ Z, Ülger BV, Yılmaz A et al. Mean platelet volume: is it a predictive parameter in diagnosis of acute mesenteric ischemia? Int Surg. 2015;100:962-5.
22. Degerli V, Ergin I, Duran FY, Ustuner MA, Duran O. Could mean platelet volume be a reliable indicator for acute mesenteric ischemia diagnosis? a casecontrol study. Biomed Res Int. 2016;2016:9810280.
23. 23. Wang Z, Chen JQ, Liu JL, Tian L. A novel scoring system for diagnosing acute mesenteric ischemia in the emergency ward. World J Surg. 2017;41:1966-74.
24. Altintoprak F, Arslan Y, Yalkin O, Uzunoglu Y, Ozkan OV. Mean platelet volume as a potential prognostic marker in patients with acute mesenteric ischemia-retrospective study.World J Emerg Surg. 2013;8:49.
25. Bilgiç İC, Gelecek S, Ozmen MM, Kasapoglu B. The association of elevated mean platelet volume with the outcome of acute mesenteric ischemia. Blood Coagul Fibrinolysis. 2015;26:727-30.
26. Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochem Med (Zagreb). 2016;26:178-93.
27. Zhang S, Cui YL, Diao MY, Chen DC, Lin ZF. Use of platelet indices for determining illness severity and predicting prognosis in critically ill patients. Chin Med J (Engl). 2015;128:2012-8.
28. Toptas M, Akkoc İ, Savas Y, Uzman S, Toptas Y, Can MM. Novel hematologic inflammatory parameters to predict acute mesenteric ischemia.Blood Coagul Fibrinolysis. 2016;27:127-30.
29. Gunduz A, Turedi S,Mentese A,Karahan SC,Hos G,Tatli O et al.Ischemia-modified albumin in the diagnosis of acute mesenteric ischemia: a preliminary study. Am J Emerg Med. 2008;26:202-5..
30. Gunduz A, Turkmen S, Turedi S, Mentese A, Yulug E, Ulusoy H et al. Time-dependent variations inischemia-modified albumin levels in mesenteric ischemia. Acad Emerg Med. 2009;16:539-43.
31. Dundar ZD, Cander B, Gul M, Karabulut KU, Girisgin S. Serum ischemia-modified albumin levels in an experimental acute mesenteric ischemia model. Acad Emerg Med. 2010;17:1233-8.
32. Kadioğlu H, Ömür D, Bozkurt S, Ferlengez E, Memmı N,Ersoy YE, Çıpe G. Ischemia modified albumin can predict necrosis at incarcerated hernias. Dis Markers.2013;35:807-10.
33. Treskes N, Persoon AM, van Zanten ARH. Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis. Intern Emerg Med. 2017;12:821-36.
34. Uygun M, Yilmaz S, Pekdemir M, Duman C, Gürbüz YS. The diagnostic value of ischemia-modified albumin in a rat model of acute mesenteric ischemia. Acad Emerg Med. 2011;18:355-9.
35. Zhang FX, Ma BB, Liang GZ, Zhang H. Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia. Mol Med Rep.2011;4:1095-9.
36. Huang HH, Chang YC, Yen DH, Kao WF, Chen JD, Wang LM et al. Clinical factors and outcomes in patients with acute mesenteric ischemia in the emergency department. J Chin Med Assoc. 2005;68:299-306.