Özge Ecmel ONUR, Erol Erdden ÜNLÜER, Arzu DENİZBAŞI, ÖZLEM GÜNEYSEL

Karın ağrısı ile acil servise başvuran hastalarda akut cerrahi batın belirlenmesinde interlökin 6 ve tümör nekroz faktör alfa’nın rolü

Amaç: Çalışmamız, interlökin-6(IL-6) ve tümör nekroz faktör alfa (TNF)'nın acil cerrahi endikasyonu koyacak bir belirteç olup olmayacağını saptamak amacıyla yapılmıştır. Gereç ve Yöntem: Akut karın ağrısı şikayetiyle acil servise başvuran 18 yaş üzeri hastalar çalışmaya alındı. İzinleri doğrultusunda rutin tetkik ve tedavileri yapılırken ,serum IL-6 ve TNF alfa düzeyi çalışılması amacı ile kan ayrıldı. Kontrol grubu olarak belirlenen sağlıklı yetişkinlerden de serumlar ayrıldı. Bulgular: Çalışmaya 80 hasta alındı. Erkeklerde ortalama yaş 43±8, kadınlar için 51±7 idi. 80 hastanın 41'inde karın ağrısının sebebi, acil cerrahi gerektirmeyen bir sorundu. Acil cerrahi gerektirmeyen hastaların en sık altta yatan problemi idrar yolu enfeksiyonuydu. Çalışmamızdaki 39 hastaya acil cerrahi operasyon gerekti. Bu hastalarda en sık bulunan patolojinin kolesistolitiazis olduğu saptandı. Akut karın ağrısı şikayeti olan hastalarda serum TNF-alfa seviyeleri, kontrol grubundakilerin TNF-alfa seviyelerinden yüksek bulunmuştur. Cerrahi girişim gerektirmeyen karın ağrısı şikayeti bulunan hastalarla, cerrahi girişim gerektiren hastaların TNF-alfa değerleri arasında anlamlı farklılık gösterilememiştir (p>0.05). Bu hastaların serum IL-6 değerleri, kontrol grubundaki kişilerin IL-6 değerlerinden belirgin olarak yüksek bulunmuştur(p

The role of inflammatory cytokines interleukin 6 and tumor necrosis factor-alpha for detection of acute surgical abdomen in emergency room

Objectives: The aim of this study is to determine whether interleukin 6 (IL- 6) and tumor necrosis factor alpha (TNF alpha) may be markers for acute surgical abdomen. Materials and Methods: Patients over 18 years old were enrolled in the study. After a description of the study was given to the patients and their families, written informed consent was obtained. During routine laboratuary assays and treatment, blood was collected for studying IL-6 and TNF alpha levels. For the control group, healthy adults sera were studied. Results: A total of 80 patients were enrolled in the study. The mean age of the males was 43±8 years and the mean age of the females was 51±7 years. 41 patients were enrolled in the non-surgical group and the most common reason was urinary tract infection. 39 patients had surgery. In this group, the most common pathology was cholesistolithiasis. The TNF alpha levels were higher in the abdominal pain patients when compared with the TNF alpha levels of the healthy control group, but there was no statistically significant difference between surgical and non-surgical abdominal pain groups (p>0.05). The IL-6 levels were also higher in the abdominal pain patients when compared with the levels of the control group, and there was statistically significant difference between abdominal pain groups. IL-6 levels were higher in the surgical abdomen group. Conclusion: IL-6 may be a marker for surgical abdomen.

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