Can İhsan ÖZTORUN, Gökhan DEMİRTAŞ, Sabri DEMİR, Doğuş GÜNEY, Rabia DEMİR, Süleyman Arif BOSTANCI, Ahmet ERTÜRK, Ali GÜNGÖR, Aysun KARA UZUN, Gamze AVCIOĞLU, Salim NEŞELİOĞLU, Emrah ŞENEL

Çocuklarda Özefagus Korozyonu ile Dinamik Tiyol-Disülfid ve İskemi Modifiye Albumin Düzeyleri Arasındaki İlişki

Amaç: Çocukluk çağında özoagusun korozif yanıkları hayatı tehdit eden ciddi bir durumdur. Çocuklarda korozif tanısı koymada özefagoskopi yapmak yerine biyokimyasal marker ile saptamak çok önemlidir. Oksidatif stres belirteçlerinden tiyol / disülfid homeostazı ve iskemi modifiye albümin seviyelerinin belirlenmesi, korozif özofagus yanıkları için tanısal bilgiler sağlayabilir. Çalışma, çocuklarda özofagus korozyonu ile tiyol / disülfid homeostazı ve iskemi modifiye albümin düzeyleri arasındaki ilişkiyi araştırmayı amaçlamaktır. Gereç ve Yöntemler: Çalışmaya, korozif madde alımı nedeni ile özofagoskopi yapılan 18 hasta (özofagoskopi grubu) ve yaş ve cinsiyet uyumlu 18 gönüllü (kontrol grubu) dâhil edildi. Her iki grupta nativ tiyol (-SH), toplam tiyol (SH+SS), dinamik disülfid (SS), albümin ve iskemi modifiye albümin (İMA) kan seviyeleri ölçüldü. Analizler için SPSS 17.0 kullanıldı ve p <0.05 anlamlı kabul edildi. Bulgular: Özofagus yanığı olan (n = 13) ve yanık olmayan (n = 5) olguların ve kontrol grubunun (n = 18) laboratuvar sonuçları karşılaştırıldı. Özofagus yanığı olan çocukların dinamik disülfid düzeylerinde (p=0.03) ve dinamik disülfid / toplam tiyol oranında (p=0.01) yanık olmayan çocuklara göre azalma görüldü veya istatistiksel olarak anlamlı bulundu. Sonuç: Disülfid seviyesi ve dinamik disülfid / total tiyol oranının azalmasından dolayı özefagus korozyonu göstermek için bir laboratuvar testi olarak kullanılabilir. Ancak, çok merkezli, randomize, daha fazla örneklemli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

korozif özefagus yanıkları, çocuk, oksidatif stres, tiyol-disülfid dengesi, iskemi modifiye albumin

The Relationship Between Esophageal Corrosion and Dynamic Thiol-Disulfide and Ischemia Modified Albumin Levels in Children

Objective: Corrosive burns of esophagus occurring in childhood has life-threatening complications. Its detection via biochemical substrates instead of performing esophagoscopy is crucially important for children. Determination of oxidative stress markers including thiol/disulfide homeostasis and ischemia modified albumin levels may provide valuable information for corrosive esophageal burns. The study aims to investigate the relation between esophageal corrosion and thiol/disulfide homeostasis and ischemia-modified albumin levels in children. Material and Methods: Eighteen patients who underwent esophagoscopy due to corrosive substances intake (esophagoscopy group) and age and gender-matched 18 volunteers (control group) were included study. Blood levels of native thiol (-SH), total thiol (SH+SS), dynamic disulfide (SS), albumin and ischemia modified albumin (IMA) were measured in both groups. SPSS 17.0 was used for analyses and p <0.05 was considered significant. Results: Laboratory results of cases with esophageal burn (n = 13) and without burn (n = 5) and control (n = 18) were compared. There was a significant decrease in levels of dynamic disulfide (p=0.03), and dynamic disulfide/total thiol ratio (p=0.01) of children with esophageal burn compared with that of children with no burn or were found to be statistically significant. Conclusion: Decreased levels of disulphide and dynamic disulfide/total thiol ratio would be used as a laboratory test to show corrosion in the esophagus. However, randomized, multicentric studies with larger samples are needed.

Keywords:

Corrosive esophageal burns;, oxidative stress, thiol/disulfide homeostasis, Ischemia Modified Albumin, children,

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