Gülşah ALYAR, Nurinnisa ÖZTÜRK, Özgür YÖRÜK, Özge Nur TÜRKERİ, Nuri BAKAN

Çocuklarda Oksidatif Stres ile Adenotonsiller Hipertrofi Arasındaki İlişki

Amaç: Bu çalışmada obstrüktif adenotonsiller hipertrofisi olan çocukların ameliyat öncesi ve sonrası oksidatif stres düzeylerinin değerlendirilmesi ve elde edilen verilerin sağlıklı çocuklarla karşılaştırılması amaçlandı. Gereç ve Yöntemler: 2015 yılı Mart-Eylül ayları arasında yapılan prospektif çalışmaya 25 hasta ve 25 sağlıklı kontrol dahil edilmiştir. Araştırma örnekleminde hasta grubuna kronik tonsillit, horlama ve ağızdan nefes alma şikayeti ile adenotonsiller hipertrofi tanısı alan ve adenotonsillektomi planlanan çocuklar dahil edilmiştir. Serum ve idrar örneği hasta grubundan ameliyat öncesi ve sonrası iki kez, kontrol grubundan bir kez alındı. Tüm numunelerin 8-hidroksi-2-deoksiguanozin düzeyleri EIA yöntem, protein karbonil düzeyleri ELISA yöntem ve malondialdehit düzeyleri manuel spektrofotometrik yöntem kullanılarak belirlenmiştir. Bulgular: Çalışmada adenotonsiller hipertrofisi olan çocukların serum malondialdehit düzeylerinin kontrol grubuna göre anlamlı olarak yüksek olduğu (p=0.003) ve diğer parametreler açısından fark olmadığı (p>0.05) bulunmuştur. Ameliyattan sonra değerlendirilen her üç parametrenin de öncekine göre anlamlı düzeyde azaldığı tespit edilmiştir (p<0.05). Operasyon öncesi malondialdehit ile 8-hidroksi-2- deoksiguanozin değerleri arasında istatistiksel olarak anlamlı ve zayıf bir korelasyon olduğu belirlenmiştir (p=0.003, r=0.566). Sonuç: Pediatrik popülasyonda yaygın görülen hipertrofik adenotonsiller birçok klinik duruma neden olarak çocukların sağlığını ve yaşam kalitesini olumsuz etkilemektedir. Bulgularımız doğrultusunda obstrüktif ATH’li çocuklarda serum ve idrar MDA düzeyleri ile doku PCO düzeylerinin oksidatif hasarın değerlendirilmesinde yararlı belirteçler olduğunu ve hastalığın etyopatogenezini aydınlatmaya yardımcı olabileceğini söyleyebiliriz. ATH sağlık üzerindeki olumsuz etkileri sebebiyle hastalığın klinik, biyokimyasal ve histopatolojik çalışmalarının daha geniş bir örneklem grubunda incelenmesi önerilmektedir. Anahtar Sözcükler: Adenotonsiller hipertrofi, 8-hidroksi-2-

Anahtar Kelimeler:

Adenotonsiller hipertrofi, 8-hidroksi-2-deoksiguanozin, malondialdehit, protein karbonil

The Relationship Between Oxidative Stress and Adenotonsillar Hypertrophy in Children

Objective: In this study, it was aimed to evaluate the preoperative and postoperative oxidative stress levels of children with obstructive adenotonsillar hypertrophy and to compare the obtained data with healthy children. Material and Methods: 25 patients and 25 healthy controls were included in the prospective study conducted between March and September 2015. In the study sample, children who were diagnosed with adenotonsillar hypertrophy due to chronic tonsillitis, snoring and mouth breathing and who were planned for adenotonsillectomy were included in the patient group. Control group included 25 healthy volunteers with the same demographic characteristics. Serum and urine samples were collected from the patient group twice, before and after surgery, and once from the control group. 8-hydroxy-2-deoxyguanosine levels of all samples were determined by EIA method, protein carbonyl levels were determined by ELISA method and malondialdehyde levels were determined by manual spectrophotometric method. Results: In the study, it was found that the serum malondialdehyde levels of children with adenotonsillar hypertrophy were significantly higher than the control group (p=0.003) and that there was no difference in terms of other parameters (p>0.05). After the operation, it was determined that the levels of all three parameters evaluated significantly decreased compared to before (p<0.05). It was determined that there was a statistically significant and weak correlation between malondialdehyde and 8-hydroxy-2-deoxyguanosine values before the operation (p=0.003, r=0.566). Conclusion: Hypertrophic adenotonsillar, which is common in the pediatric population, causes many clinical conditions and adversely affects the health and quality of life of children. In line with our findings, we can say that serum and urine MDA levels and tissue PCO levels are useful markers in the evaluation of oxidative damage in children with obstructive ATH and may help to elucidate the etiopathogenesis of the disease. Considering the effects of ATH on health, it is recommended to be considered as an important health problem and to examine the clinical, biochemical and histopathological studies of the disease in a larger sample group.

Keywords:

Adenotonsillar hypertrophy, 8-hydroxy-2-deoxyguanosine, malondialdehyde, protein carbonyl,

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