Pentoksifilinin myokardiyal iskemi-reperfüzyon hasarına etkileri
Küçük Resim Yok
Tarih
1998
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
GATA
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Miyokardiyal iskemi-reperfüzyon hasarı üzerine pentoksifilinin etkisi 10 mongreal köpek kalbinde araştırıldı. Deneklerin 5'i çalışma, 5'i kontrol grubu olarak alındı. Çalışma grubuna 10 gün boyunca 200 mg/gün pentoksifilin intramusküler enjekte edildi. Her iki gruptaki deneklerde LAD oklüde edildi ve 60 dakikalık iskemi periyodundan sonra kardiyopulmoner bypass'a girildi ve St. Thomas II kardiyoplejisi verilerek kalp durduruldu. 75 dakikalık kross klemp süresinden sonra LAD'deki oklüzyon kaldırıldı. Sıcak kan kardiyoplejisi verildikten sonra kross klemp açıldı. Deneklerin tümünde oklüzyonun 60. dakikasında Kreatininfosfokinaz miyokardiyal band (CK-MB), Laktik Dehidrojenaz (LDH) ve Laktat seviyesi için koroner sinüsten kan örnekleri alındı. Her iki grupta da çalışma süresince CVP, MAP, PAP ve PCWP devamlı olarak takip edildi. Kardiyopulmoner bypasstan çıkıldıktan 6 saat sonra sol ventrikülden transmural biyopsi alındı. Çalışma grubunda iskemi süresince hiç bir denekte ventriküler fibrilasyon (VF) ve hemodinamik bozulma görülmez iken kontrol grubunda iki denekte VF ve hemodinamik bozulma gelişti. Çalışma grubunda oklüzyon döneminde kardiyak indeks (CI) 3.2±0.5 It/m2 kontrol grubunda ise 2.7±0.5 It/m2 olarak bulundu. Reperfüzyon döneminde kontrol grubunda CI 1., 3., 5. saatlerde sırasıyla 2.8±0.3, 3.1±0.2, 3.3±0.5 It/m2 iken çalışma grubunda aynı değerler 3.0±0.3, 3.8±1.2, 3.7±0.9 It/m2 olarak saptandı (p<0.05). Kardiyopulmoner bypasstan çıkışta, kontrol grubunda üç denekte inotropik destek ihtiyacı duyulurken çalışma grubunda hiç bir denekte inotrop gereksinimi olmadı. Kontrol grubunda reperfüzyon döneminde Laktat, CK-MB, LDH seviyeleri sırası ile 41±6 mmol/L,137±4 Ü/L ve 1170±150 Ü/L olarak sap-tanırken çalışma grubunda aynı değerler sırası ile 32±2 mmol/L, 76±6 Ü/L ve 550±75 Ü/L olarak saptandı (p<0.05). Ultrastrüktürel incelemelerde kontrol grubunda kloner skorlaması 3 iken çalışma grubunda 1 olarak değeriendirildi. Sonuç olarak; Pentoksifilin 5'- nükleotidaz enzimini bloke ederek mitokondriyal alanda adenozin kaybını engeller, miyokardın iskemi ve reperfüzyon hasarını anlamlı ölçüde azaltır.
The influence of pentoxifilin on ischemia/reperfusion damage was studied in the heart of ten Mongreal dogs. Group I (Pentoxifilin)=5, Group II (Control)=5. Pentoxifilin 200 mg/day was administrated IM in grup I during the 10 days period. LAD was occluded by the snare in both groups and cardiopulmonary bypass was initiated after 60 minutes' ischémie period. Dog hearts were arrested with St. Thomas II cardioplegia and after the 15 minute cross clamp time, occlusion of LAD was ended. Cross-clamp removed. Blood samples were collected from the coronary sinus in the 60. minutes of occlusion and CK-MB, LDH and Lactac level were measured. CVP,MAP,PAP and PAWP were recorded. Myocardial transmural biop-sies were taken 6 hour later the end of cardiopulmonary bypass. Ventricular fibrillation and hemodynamic instability were not developed in group I but in two dogs in group II. Cardiac index (CI) average was 3.2±0.5 It/m2 in group I, 2.7±0.5 It/m2 in group II. Average cardiac index in reperfusion period were measured in 1,3., 5. hours. Average Cardiac index in group II in same intervals as follows, 2.8±0.3, 3.1 ±0.2, 3.3±0.5 It/m2 butin Group I 3.0±0.3, 3.8±1.2, 3.7±0.9 It/m2 (p<0.05). Inotropic requirement-was developed in 3 dogs in group II but none in groupé During/the reperfusion period Lactate, CK-MB and LDH levels in group II and I are as follows; 41 ±6 mmot/lt, 137±4 Ü/L, 1170±150 in group II and 32±2, 76±6, 550±75 Ü/L in group I (p<0.05). Kloners' scoring was one in group I and three in group II in the ultrastructurâl examination.It is concluded that pretreatment with pentoxifilin, which is blocker of 5'-nucleotidase enzyme prevents the loosing of the adenosine in the mitochondrial space and reduces the ischémie and reperfusion injury significantly.
The influence of pentoxifilin on ischemia/reperfusion damage was studied in the heart of ten Mongreal dogs. Group I (Pentoxifilin)=5, Group II (Control)=5. Pentoxifilin 200 mg/day was administrated IM in grup I during the 10 days period. LAD was occluded by the snare in both groups and cardiopulmonary bypass was initiated after 60 minutes' ischémie period. Dog hearts were arrested with St. Thomas II cardioplegia and after the 15 minute cross clamp time, occlusion of LAD was ended. Cross-clamp removed. Blood samples were collected from the coronary sinus in the 60. minutes of occlusion and CK-MB, LDH and Lactac level were measured. CVP,MAP,PAP and PAWP were recorded. Myocardial transmural biop-sies were taken 6 hour later the end of cardiopulmonary bypass. Ventricular fibrillation and hemodynamic instability were not developed in group I but in two dogs in group II. Cardiac index (CI) average was 3.2±0.5 It/m2 in group I, 2.7±0.5 It/m2 in group II. Average cardiac index in reperfusion period were measured in 1,3., 5. hours. Average Cardiac index in group II in same intervals as follows, 2.8±0.3, 3.1 ±0.2, 3.3±0.5 It/m2 butin Group I 3.0±0.3, 3.8±1.2, 3.7±0.9 It/m2 (p<0.05). Inotropic requirement-was developed in 3 dogs in group II but none in groupé During/the reperfusion period Lactate, CK-MB and LDH levels in group II and I are as follows; 41 ±6 mmot/lt, 137±4 Ü/L, 1170±150 in group II and 32±2, 76±6, 550±75 Ü/L in group I (p<0.05). Kloners' scoring was one in group I and three in group II in the ultrastructurâl examination.It is concluded that pretreatment with pentoxifilin, which is blocker of 5'-nucleotidase enzyme prevents the loosing of the adenosine in the mitochondrial space and reduces the ischémie and reperfusion injury significantly.
Açıklama
Anahtar Kelimeler
Kaynak
Gülhane Askeri Tıp Akademisi Bülteni
WoS Q Değeri
Scopus Q Değeri
Cilt
40
Sayı
2
Künye
Demirkılıç, U., Kuralay, E., Cıncık, M., Yüksel, M., İde, T., Usubütün, A., Yılmaz, A. ve Tatar, H. (1998). Pentoksifilinin myokardiyal iskemi-reperfüzyon hasarına etkileri / The influence of pentoxifilin on myocardial ischemia-reperfusion injury. Gülhane Askeri Tıp Akademisi Bülteni, GATA. 40(2), s. 135 - 142.
