Sigara içenlerde nazal mukosilier transport hızının 99m Tc-Makroagregat albumin kullanılarak rinosintigrafi ile değerlendirilmesi
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Tarih
2015
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Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Nazal mukosilier klirens solunan havadaki yabancı partiküllerin zararlı etkilerine karşı solunum yollarının korunmasında rol oynayan vücudun önemli savunma mekanizmalarından biridir. Sigaranın nazal mukosilier klirens üzerindeki etkisini araştıran farklı tekniklerle yapılmış birçok çalışma mevcuttur. Bu çalışmalarda bazı araştırmacılar sigaranın nazal mukosilier aktiviteyi bozduğunu bildirirken diğerleri ise bunun tersine, sigaranın nazal mukosilier aktiviteyi olumsuz yönde etkilemediğini ileri sürmüşlerdir. Biz bu çalışmada, sigaranın nazal mukosilier transport hızı (NMTH) üzerindeki etkisini rinosintigrafi ile araştırmayı amaçladık. Bu çalışmaya 18-55 yaş arası, sigara içen 48 kişi (8 kadın, 40 erkek) ve sigara içmeyen 30 gönüllü (8 kadın, 22 erkek) dahil edildi. Tüm gönüllüler KBB ve Göğüs hastalıkları uzmanları tarafından muayene edildi. NMTH’nı olumsuz yönde etkileyebilecek nazal, paranazal ve sistemik hastalıkları olanlar, 18 yaşından küçükler ve gebeler çalışmaya alınmadı. Tüm vakalara 99mTc-MAA ile rinosintigrafi yapılarak NMTH’ları hesaplandı. Rinosintigrafi ile ölçülen NMTH’larının tekrarlanabilirliğini göstermek amacıyla 13 sağlıklı gönüllüye aynı gün içinde birkaç saat arayla iki çekim yapılarak iki kez NMTH’ları hesaplandı. Sigara içenlerde ortalama NMTH’ı 5,7 ± 3,1 mm/dk, kontrol grubunda ise 9,2 ± 3 mm/dk olarak hesaplandı. Yapılan istatistik analizde sigara içenlerin NMTH’ları kontrol grubuna göre anlamlı derecede düşük bulundu (p<0.0001). Çift çekim yapılan 13 kişide birinci çekimde hesaplanan ortalama NMTH’ı 7,9 ± 3,4 mm/dk, ikinci çekimde ise 7,7 ± 3,3 mm/dk olarak bulundu. Bu iki değer karşılaştırıldığında arada istatistiksel olarak anlamlı fark bulunmadı (p>0.05). Ayrıca sigara içenlerde ölçülen NMTH’ları ile sigara içme yılı, günlük içilen paket sayısı ve paket-yıl arasında istatistiksel olarak anlamlı bir korelâsyon bulunmadı (p>0.05). Sonuç olarak, rinosintigrafi testi tekrarlanabilir NMTH sonuçları vermektedir. Bu çalışmada elde ettiğimiz bulgular Sigara içmenin NMTH’nı azalttığını göstermektedir (p<0.0001). ANAHTAR SÖZCÜKLER: Burun mukozası, mukosilier klirens, Tc-99m MAA, sintigrafi, sigara içme
Nasal mucociliary clearance is one of the important defence mechanisms in human body that enrolls in protecting the respiratory tract from foreign particles in inspired air. There are many researches that address the hazardous effects of the cigarette smoking on nasal mucociliary clearance. Of them, some have reported that the cigarette smoking impaired the nasal mucociliary transport rate (NMTR) whereas others have suggested that the NMTR was not negatively affected by smoking. In this study we aimed to investigate the effect of cigarette smoking on NMTR by rhinoscintigraphy. Forty eight person aged between 18-55 years who were cigarette smokers (8 female, 40 male) and 30 volunteers who were not smokers enrolled in this study. All of them were examined by both ear-nose-throat specialists and pulmonologist. Persons having ongoing nasal, paranasal and systemic diseases, ones under the age of 18 years and pregnants were excluded from the study. NMTRs were calculated by the rhinoscintigraphy using 99mTc-macroaggregated albumin in all cases. To determine reproducibility of the rhinoscintigraphy, NMTRs were calculated 2 times on rhinoscintigraphy images that were performed in a same day and several hours interval in 13 healthy volunteers. The mean NMTR of smokers was 5.7 ± 3.1 mm/min whereas it was 9.2 ± 3 mm/min in controls. Statistical analysis showed that the mean NMTRs of smokers was significantly lower than that of controls (p<0.0001). In twice imaging group, the mean NMTR calculated on first rhinoscintigraphy imagings was calculated as 7.9 ± 3.4 mm/min and second one was 7.7 ± 3.3 mm/min. We did not find statistically significant difference between these two NMTR values (p>0.05). Additionally, we found no statistically significant correlation between NMTRs and smoking years, no of pack of cigarettes per day and pack years of cigarette smoking in smokers (p>0.05). In conclusion, based upon our study findings we suggest that the rhinoscintigraphy gives reproducible NMTR results and cigarette smoking significantly decrease the NMTR in cigarette smokers. KEYWORDS: Nasal mucosa, mucociliary clearance, Tc-99m MAA, scintigraphy, cigarette smoking
Nasal mucociliary clearance is one of the important defence mechanisms in human body that enrolls in protecting the respiratory tract from foreign particles in inspired air. There are many researches that address the hazardous effects of the cigarette smoking on nasal mucociliary clearance. Of them, some have reported that the cigarette smoking impaired the nasal mucociliary transport rate (NMTR) whereas others have suggested that the NMTR was not negatively affected by smoking. In this study we aimed to investigate the effect of cigarette smoking on NMTR by rhinoscintigraphy. Forty eight person aged between 18-55 years who were cigarette smokers (8 female, 40 male) and 30 volunteers who were not smokers enrolled in this study. All of them were examined by both ear-nose-throat specialists and pulmonologist. Persons having ongoing nasal, paranasal and systemic diseases, ones under the age of 18 years and pregnants were excluded from the study. NMTRs were calculated by the rhinoscintigraphy using 99mTc-macroaggregated albumin in all cases. To determine reproducibility of the rhinoscintigraphy, NMTRs were calculated 2 times on rhinoscintigraphy images that were performed in a same day and several hours interval in 13 healthy volunteers. The mean NMTR of smokers was 5.7 ± 3.1 mm/min whereas it was 9.2 ± 3 mm/min in controls. Statistical analysis showed that the mean NMTRs of smokers was significantly lower than that of controls (p<0.0001). In twice imaging group, the mean NMTR calculated on first rhinoscintigraphy imagings was calculated as 7.9 ± 3.4 mm/min and second one was 7.7 ± 3.3 mm/min. We did not find statistically significant difference between these two NMTR values (p>0.05). Additionally, we found no statistically significant correlation between NMTRs and smoking years, no of pack of cigarettes per day and pack years of cigarette smoking in smokers (p>0.05). In conclusion, based upon our study findings we suggest that the rhinoscintigraphy gives reproducible NMTR results and cigarette smoking significantly decrease the NMTR in cigarette smokers. KEYWORDS: Nasal mucosa, mucociliary clearance, Tc-99m MAA, scintigraphy, cigarette smoking
Açıklama
Anahtar Kelimeler
Burun mukozası, Nasal mucosa, Mukosilier klirens, Mucociliary clearance, Tc-99m MAA, Sintigrafi, Scintigraphy, Sigara içme, Cigarette smoking
