Pektus Bar’lı Olguların Serum ve İdrar Örneklerinde Eser Elementlerin Değerlendirilmesi

Amaç: Göğüs deformitelerinin metal alaşımlı barlar vasıtasıyla rekonstrüksiyon yönteminin kullanılması, metal barlara bağlı eser elementlerin vücuda yayılmasına da sebep olabilmektedir. Bu çalışma, pektus bar kullanılan sınırlı sayıda olguda serum ve idrarlarında bar alaşımı olan Demir(Fe), Nikel(Ni) ve Krom(Cr) seviyeleri analiz edilmiş ve literatürle karşılaştırılarak bir ön çalışma olarak sunulması amaçlanmıştır. Yöntemler: Daha önce bar takılmış11 Erkek (E) ve 3 Kadın (K) toplam 14 olgunun ortalama bar kalış süresi 39,70 (7- 60) ay sonunda alınan serum ve idrarlarında Fe, Ni ve Cr seviyeleri çözündürülerek indüktif plazma kütle spektrofotometresi (ICP-MS) cihazı ile değerlendirildi. Sonuçlar literatür ile karşılaştırıldı. Bulgular: Serum Fe ve Ni seviyeleri normal değerler arasında saptanırken serum Cr seviyesi normal değerlerden yüksek saptanmıştır. İdrar da ise Fe ve Cr atılımı normalin çok üstünde bulunurken Ni idrarda normal seviyede saptanmıştır. Sonuç: İdrar Fe atılımı arttırılarak serum Fe seviyesinin normal tutulması sağlanabilmiş, ancak idrar Cr atılımı artmasına rağmen serum Cr seviyesi yüksek saptanmıştır. Bu da yüksek Cr serum seviyesinin vücutta birikici etki oluşturabileceği şeklinde yorumlanmıştır.

Evaluation of Trace Elements in Serum and Urine Samples of Patients with Pectus Bar

Objective: The use of metal alloy bars in the reconstruction of thoracic deformities causes spread of trace element into the body. The aim of our study was to analyses and compare the levels of common alloy bar elements such as Iron (Fe), Nickel (Ni) and Chromium (Cr) in the serum and urine samples in a limited number of cases using pectus bars with the available literature reviews. Method: The levels of Fe, Ni, and Cr in the serum and urine samples of 14 patients (11 males, 3 females) with an average pectus bar treatment duration of 39,70 (7-60) months were determined (just before removal of the bar) using Inductive Plasma Mass Spectrophotometry (ICP-MS). Results: The serum Fe and Ni levels were found to be within the normal range while Cr levels were found to be higher than normal. On the other hand, the levels of Fe and Cr excretion were found to be higher than normal in the urine while Ni level was found to be normal. Conclusion: The serum Fe level was kept normal as a result of the increase in the urine Fe excretion whereby serum Cr level was found to be higher than normal despite the increase in excretion of Cr in the urine. Therefore, the higher serum Cr level may have resulted as accumulative effect of Cr in the body.

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