Ahmet ÖKTEM, Ayşegül ZENCİROĞLU, Ahmet ÖZYAZICI, Duygu BİDEV, Emine ÖZÇELİK, Dilek DİLLİ, Özcan EREL

Yenidoğan Dönemi Pnömoni Vakalarında Dinamik Tiyol/Disülfit Dengesi

Amaç: Yenidoğan döneminin önemli enfeksiyonlarından biri olan pnömoni akciğerlerin enflamasyonu ile giden bir klinik tablodur. Solunum sıkıntısı olan her yenidoğan pnömoni açısından dikkatli değerlendirilmelidir. Dinamik tiyol-disülfid homeostazı antioksidan koruma, apoptoz, enzim aktivitesinin düzenlenmesi ve detoksifikasyon gibi birçok mekanizmada rol almaktadır. Bu çalışma ile yenidoğan dönemi pnömoni hastalarında tiyol-disülfid dengesini belirlemeyi amaçladık. Gereç ve Yöntemler: Çalışmaya Ocak 2019- Ocak 2020 tarihleri arasında pnömoni tanısı ile yatırılan 40 olgu ve kontrol grubu olarak yenidoğan polikliniğinde değerlendirilen 40 sağlıklı yenidoğan bebek, toplam 80 olgu alındı. Hasta grubunda tüm olguların fizik muayene bulguları, tam kan sayımı ve biyokimya sonuçları, akciğer grafisi, kan kültürü ve viral PCR sonuçları kaydedildi. Tüm olguların disülfid, nativ tiyol ve total tiyol değerleri çalışıldı ve oranları hesaplandı. İstatistik metodu olarak Ki-Kare testi, Independent t-testi ve Mann-Whitney-U testi kullanıldı. Çalışmada p˂0,05 değeri anlamlı olarak kabul edildi. Bulgular: Gruplar arasında cinsiyet dağılımı, doğum şekli, gebelik haftası ve doğum ağırlığı ortalaması açısından anlamlı fark bulunmadı (p˃0,05). Pnömoni grubunda tedavi öncesi disülfid düzeyinin nativ ve total tiyol düzeylerine oranı yüksek iken tedavi sonrası düştüğü tespit edildi (p˂0,05). Pnömoni grubunda tedavi öncesi disülfid düzeyinin nativ ve total tiyol düzeylerine oranı kontrol grubuna göre yüksek iken(p˂0,05), tedavi sonrası oranların kontrol grubu ile benzer olduğu görüldü. Sonuç: Bu çalışmadaki pnömoni hastalarında tedavi öncesi disülfid düzeyindeki artış ile birlikte serum nativ tiyol ve total tiyol oranlarının düşüklüğü oksidatif stresi gösterirken, tedavi sonrası tiyol düzeylerinin kontrol grubundaki gibi yüksek bulunması oksidatif stresin gerilediğini göstermektedir. Çok düşük serum düzeyleri ile çalışılabilen tiyol-disülfid dengesi tanı ve tedavi takibinde destekleyici olacaktır.

Anahtar Kelimeler:

Pnömoni, yenidoğan, tiyol-disülfid dengesi, oksidatif stres

Dynamic Thiol / Disulfide Homeostasis in Neonatal Pneumonia

Objective: Pneumonia, is an important infection of the newborn period and clinic status goes with inflammation of the lungs. Every newborn with respiratory distress should be carefully evaluated for pneumonia. Dynamic thiol-disulfide homeostasis is involved in many mechanisms such as antioxidant protection, apoptosis, regulation of enzyme activity and detoxification. The aim of this study is to determine the thiol-disulfide homeostasis in neonatal pneumonia. Material and Methods: We included data of a total of 80 cases in study, 40 patients with neonatal pneumonia and 40 healthy cases in control group admitted to hospital between January 2019- January 2020. Physical examination findings, blood count and biochemistry results, chest radiography, blood culture and viral PCR results were recorded in the patient group. Disulfide, native thiol and total thiol levels of all cases were determined and their rates were calculated. Pearson’s chi-square test, Independent t-test and Mann-Whitney-U test were used for statistical analysis, and p<0.05 was considered significant. Results: There was no significant difference between the groups in terms of gender distribution, type of delivery, gestational week and mean of birth weight (p>0.05). Before treatment disulfide levels were higher than native and total thiol levels in the patients with pneumonia and we have seen decreased disulfide levels after treatment (p<0.05). The ratio of pre-treatment disulfide level to native and total thiol levels in pneumonia group was higher than the control group (p<0.05). But the ratio of disulfide level to native and total thiol levels after treatment were similar to the control group. Conclusion: High pre-treatment disulfide level and low serum native thiol and total thiol levels showed oxidative stress in patients with pneumonia, while the higher thiol levels after treatment as like control group showed that oxidative stress regressed. The thiol-disulfide homeostasis, which can be studied with very low serum levels, will be supportive in diagnosis and treatment follow-up.

Keywords:

Thiol-disulfide homeostasis, Pneumonia, Oxidative stress, Newborn,

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