Akut iskemik inmede plazma miyeloperoksidaz seviyeleri ve prognoz üzerine etkisi
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Tarih
2015
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Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
İskemik inme, beyin dokusunda meydana gelen infarkt nedeni ile ani olarak ortaya çıkan patolojik bir durumdur. Bunlar arasında en fazla üzerinde durulan, inmede inflamasyonun rolüdür. Aterogenez ve akut serebral iskemide inflamatuar süreçlerin rol oynadığına dair deliller giderek artmaktadır. Oksidatif stres ve inflamasyon, aterosklerozun patogenezine katkıda bulunur. Miyeloperoksidaz (MPO) enzimi, oksidatif strese yanıt olarak lökositlerden salgılanan lizozomal bir enzimdir. Lökositelerde bolca bulunan ve reaktif oksidan ürünler oluşturan MPO aterosklerotik reaksiyonlarda bulunur ve katalitik aktivite gösterir. Biz bu çalışmada akut iskemik inme ile gelen hastaların miyeloperoksidaz plazma düzeylerinin prognoz üzerine etkisini araştırdık. Akut iskemik serebrovasküler hastalık tanısı alan 55 hasta ile kontrol grubu olarak yaş ve cinsiyet dağılımı uyumlu 40 sağlıklı birey prospektif olarak değerlendirmeye alındı. Hastalardan inmeyi takiben ilk 24 saat ve 5. gün kan örnekleri alınırak plazma miyeloperoksidaz düzeylerine bakıldı. Hasta grubunun miyeloperoksidaz düzeyleri kontrol grubuna kıyasen anlamlı derecede yüksekti (p<0.0001). Hasta grubunda sağ kalanların ve ilk 6 ay içinde ölenlerin myeloperoksidaz düzeyleri karşılaştırıldığında, miyeloperoksidaz yükseliği mortalite yönünde anlamlı olarak yüksek bulunmuştur (p<0.000). Sonuç olarak çalışmamız akut iskemik inmeli hastalarda plazma miyeloperoksidaz düzeyinin arttığını, ve plazma miyeloperoksidaz düzeyinin prognozla ilişkisinin olduğunu göstermektedir. Miyeloperoksidaz düzeyinin aterogenezdeki ve inme sonrası olusan inflamatuar yanıttaki rollerinin daha iyi anlaşılabilmesi için yeni ve kapsamlı çalısmalara ihtiyaç vardır. ANAHTAR SÖZCÜKLER: Akut iskemik inme, miyeloperoksidaz, inflamasyon, mortalite, ateroskleroz.
Ischemic stroke is a pathological condition with acute onset that is caused by the infarction of brain tissue. The most commonly mentioned etiological factor among those is the role of inflammation in stroke. There is a growing number of evidence suggesting the role of inflammatory process in the etiology of aterogenesis and acute cerebral ischemia. Oxidative stress and inflammation also contribute into pathogenesis of atherosclerosis. Myeloperoxidase enzyme (MPO) is a lyzozomal enzyme secreted from leukocyte as a response to oxidative stress. MPO, as an enzyme present in abundant amount in leucocytes and creating reactive oxidant metabolites, plays an active role in atherosclerotic reactions and presents catalytic activity. The aim of this study was to evaluate the effect of myeloperoxidase levels on the prognosis of acute ischemic stroke patients. The sample of the study consisted of 55 inpatients who received a diagnosis of acute ischemic cerebrovascular disease and 40 healthy age and sex matched individual as a control group. Plasma MPO levels of the patients have been measured in the first 24 hours after initial stroke and at the 5th day after stroke. MPO levels in the patients were significantly higher than the control group (p<0.0001). Increased levels of MPO was an important indicator for mortality as patients who survived six months had significantly lower levels of MPO than the ones who deceased (p<0.0001). The results of this study have showed that plasma MPO levels significantly increase in acute ischemic stroke patients and had a significant correlation with prognosis. Larger studies are warranted for better understanding of the role of MPO levels in inflammatory response that appears after aterogenesis and post stroke periods. KEYWORDS: Acute ischemic stroke, myeloperoxidase, inflammation, mortality , atherosclerosis
Ischemic stroke is a pathological condition with acute onset that is caused by the infarction of brain tissue. The most commonly mentioned etiological factor among those is the role of inflammation in stroke. There is a growing number of evidence suggesting the role of inflammatory process in the etiology of aterogenesis and acute cerebral ischemia. Oxidative stress and inflammation also contribute into pathogenesis of atherosclerosis. Myeloperoxidase enzyme (MPO) is a lyzozomal enzyme secreted from leukocyte as a response to oxidative stress. MPO, as an enzyme present in abundant amount in leucocytes and creating reactive oxidant metabolites, plays an active role in atherosclerotic reactions and presents catalytic activity. The aim of this study was to evaluate the effect of myeloperoxidase levels on the prognosis of acute ischemic stroke patients. The sample of the study consisted of 55 inpatients who received a diagnosis of acute ischemic cerebrovascular disease and 40 healthy age and sex matched individual as a control group. Plasma MPO levels of the patients have been measured in the first 24 hours after initial stroke and at the 5th day after stroke. MPO levels in the patients were significantly higher than the control group (p<0.0001). Increased levels of MPO was an important indicator for mortality as patients who survived six months had significantly lower levels of MPO than the ones who deceased (p<0.0001). The results of this study have showed that plasma MPO levels significantly increase in acute ischemic stroke patients and had a significant correlation with prognosis. Larger studies are warranted for better understanding of the role of MPO levels in inflammatory response that appears after aterogenesis and post stroke periods. KEYWORDS: Acute ischemic stroke, myeloperoxidase, inflammation, mortality , atherosclerosis
Açıklama
Anahtar Kelimeler
Akut iskemik inme, Acute ischemic stroke, Miyeloperoksidaz, Myeloperoxidase, İnflamasyon, Inflammation, Mortalite, Mortality, Ateroskleroz, Atherosclerosis
