Ali TAŞKIRAN, Sevgi ESKİOCAK, Mustafa ÇIKIRIKÇIOĞLU, Turan EGE, Enver DURAN

Koroner arter bypass cerrahisi öncesindeki plazma total antioksidan kapasite düzeylerinin iskemi-reperfüzyon hasarı ile ilişkisi

Amaç: Miyokardiyumda iskemi-reperfüzyon sırasında oluşan hasarın oksidatif stresten kaynaklandığı ileri sürülmektedir. Bu çalışmada bazal total antioksidan kapasite (TAOK) düzeyinin iskemi-reperfüzyon hasarına olan etkisi incelendi. Hastalar ve Yöntemler: Koroner bypass ameliyatı uygulanan 21 hastanın koroner sinüslerinden koroner bypass başlamadan önce (bazal durum), iskemi sonunda, çapraz klemp kaldırıldıktan beş dakika sonra (erken reperfüzyon) ve yan klemp kaldırıldıktan 15 dakika sonra (geç reperfüzyon) kan örnekleri alındı. Total antioksidan kapasite, lipid peroksit (LPO) ve laktat dehidrogenaz (LDH) düzeyleri ölçüldü. Hastalar bazal TAOK düzeyine göre iki gruba ayrıldı: TAOK değeri %60'dan düşük bulunan 10 olgu grup I'i (8 erkek, 2 kadın; ort. yaş 57), %60 veya üzeri olan 11 olgu grup II'yi (10 erkek, 1 kadın; ort. yaş 53) oluşturdu. Bulgular: Ameliyat süresince her iki grupta da LDH ve LPO düzeyleri ameliyat döneminde artarken, TAOK düzeylerinin baskılandığı görüldü. Grup I’de LDH ve LPO salınımı grup II’den fazla idi. Ameliyat öncesi ve ameliyat süresince TAOK düzeyleri grup I'de grup II'den anlamlı derecede düşük bulundu (ameliyat öncesi, iskemi ve erken reperfüzyon dönemleri için p

Anahtar Kelimeler:

Oksidatif stres, Miyokard iskemisi, Biyolojik belirteçler, Antioksidanlar, Koroner arter köprüleme, Reperfüzyon hasarı, Lipid peroksidasyonu

The relationship between preoperative plasma total antioxidant capacity and ischemia-reperfusion injury in patients undergoing coronary artery bypass surgery

Objectives: Oxidative stress has been implicated in the occurrence of myocardial injury during ischemia-reperfusion. The aim of this study was to investigate the effect of basal total antioxidant capacity (TAOC) on ischemiareperfusion injury. Patients and Methods: Blood samples were taken from the coronary sinus of 21 patients prior to coronary bypass (basal), at the end of ischemia, five minutes after the removal of the cross clamp (early reperfusion), and 15 minutes after the removal of the lateral clamp (late reperfusion). The levels of TAOC, lipid peroxide (LPO), and lactate dehydrogenase (LDH) were determined. The patients were divided into two groups as follows: group I included 10 patients (8 males, 2 females, mean age 57 years) with TAOC <%60 and group II included 11 patients (10 males, 1 female, mean age 53 years) with TAOC .%60. Results: The levels of LDH and LPO increased, while those of TAOC were suppressed in both groups throughout surgery. The levels of LDH and LPO were higher in group I than those of group II. The TOAC levels in group I were invariably and significantly lower than those of group II (for basal, ischemia, early reperfusion periods, p<0.001; late reperfusion, p<0.05). Inverse relationships were found between the basal TOAC and LPO at all the periods, and with LDH in the late reperfusion period. Conclusion: Our data suggest that basal TAOC values may be associated with ischemia-reperfusion injury and the degree of ensuing myocardial damage.

Keywords:

Oxidative Stress, Myocardial Ischemia, Biological Markers, Antioxidants, Coronary Artery Bypass, Reperfusion Injury, Lipid Peroxidation,

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