Deneysel akciğer ototransplantasyonu sonrası reperfüzyon hasar modelinde N-asetilsisteinin etkileri

Amaç: N-Asetilsistein'in iskemi sonrası reperfüzyonun başlamasıyla ortaya çıkan hasar üzerine yararlı etkileri olduğu bilinmektedir. Bu çalışma, sol akciğer Ototransplantasyonu yapılan köpeklerde reperfüzyona bağlı oluşan hemodinamik ve biyokimyasal değişikliklerde N-asetilsistein tedavisinin etkisini göstermeyi amaçlayan deneysel bir çalışmadır. Materyal ve Metod: Çalışmada rastgele 2 eşit gruba (kontrol ve N-asetilsistein) ayrılan 12 adet yetişkin sokak köpeği kullanıldı. Pulmoner arter ve venin klemplenmesi sonrası sol ana bronkus divize edildi, 2 saatlik iskemi sonrası reperfüzyonun başlamasından önce yemden anastomoz yapıldı. Kontrol grubuna (n = 6) şalin solüsyonu verildi, N-asetilsistein grubuna (n = 6) iskemiden 30 dakika önce 60 mg/kg N-asetilsistein verildi. Ardından iki saatlik süreyle 40°C Euro-Collin's ile yıkandıktan sonra ortotopik tek akciğer Ototransplantasyonu uygulandı. Reperfüzyon döneminde sağ pulmoner arterin 5 dakikalık klemplenme testinin ardından sol pulmoner arter basıncı, sol pulmoner vasküler rezistansı, kardiyak debi, sistemik arteriyel oksijen basıncı (PaO2), alveolo-arteriyel oksijen farkı(A-aDO2) değerleri ölçüldü. Ayrıca doku beta N-asetil glukozaminidaz ve süperoksiddismutaz düzeylerine bakıldı. Bulgular: Sol pulmoner arter basıncı, sol pulmoner vasküler rezistans, kalp debisi, sistemik arteriyel oksijen basıncı, alveolo-arteriel oksijen farkı ölçümleri, serum beta N-asetil glukoz-aminidaz, süperoksit-dismutaz değerleri N-asetilsistein grubunda kontrol grubuna göre anlamlı düzeyde farklı idi(p < 0.05). Sonuç: N-asetilsistein kullanımının akciğer Ototransplantasyonu uygulanan köpeklerde iskemi reperfüzyon hasarı üzerine yararlı etkileri bulunmaktadır.

Effects of N-acetylcystein in reperfusion injury after experimental lung ototransplantation model

Background: N-acetylcystein is known to have beneficial effects in ischemia-reperfusion (I/R) injury through post-ischemic reperfusion injury. The aim of study was to investigate the effects of N-acetylcystein on I/R injury in canine left, single, lung oto transplantation model. Methods: Twelve adult dogs were divided into two groups. Ischemia was induced for 2 hours by clamping the pulmonary arteries and veins. The left main bronchus was transected and re-anastomosed prior to perfusion. The control group (n = 6) was treated with saline,the N-acetylcystein group (n = 6) was treated with N-acetylcystein which was administered intravenously for 30 minutes before ischemic period. After two hours preservation with 40°C Euro-Collins solution, orthothopic left, single, lung transplantation was performed. During a 5 minute clamping test of the right pulmonary artery, left pulmonary arterial pressure, left pulmonary vascular resistance, arterial oxygen pressure (PaO2) and alveolar-arterial oxygen pressure difference (A-aDO2) were measured. Furthermore we measured tissue b N-acetylglucosaminidase and superoxide-dismutase levels. Results: Left pulmonary arterial pressure, left pulmonary vascular resistance, arterial oxygen pressure (PaO2), alveolar-arterial oxygen pressure difference measurement and serum beta N-acetylglucosaminidase and superoxide-dismutase levels were significantly better in the N-acetylcystein group than the control group (p < 0.05). Conclusion: N-acetylsystein appears to generate a protective effect on I/R injury in lung oto-transplantation in dogs.

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