Research of Importance of Thiol, CRP and Lactate in Diagnosing Mesenteric Ischemia At An Early Stage: Animal Model

Introduction and Purpose: Acute mesenteric ischemia is especially seen in the elderly population. It has an increasing incidence in today's world where the average life expectancy is increasing. Early diagnosis is the most important factor reducing morbidity and mortality, and there is still no marker with high sensitivity and specificity for early diagnosis.In this study, we aimed to find a more sensitive and specific serum marker in the early diagnosis of mesenteric ischemia by comparing thiol with the currently used markers C-reactive protein and lactate.
Materials and Methods: In our study, 32 Wistar Albino male rats, 10-12 weeks old, weighing 250-300 g, were used. 32 rats were divided into 4 groups, one of which was the control group. The superior mesenteric artery of the other 3 groups was ligated. Blood samples were taken after 2 hours from the first group, 4 hours from the second group, and 6 hours from the third group. Then the rats were sacrificed. Mesenteric ischemia and its level were observed in sacrificed subjects. The samples were separated under appropriate conditions and analyzed biochemically.
Results: As the ischemia time increased, CRP increased and this increase was found to be statistically insignificant (p>0.05). The changes in lactate were found to be statistically significant (p<0.05). The difference between the changes of total and native thiol values was found to be statistically significant (p<0.05).
Conclusion: Although CRP is a non-specific parameter in the early diagnosis of acute mesenteric ischemia, lactate maintains its importance as seen in our study. Differences in total thiol and native thiol changes were statistically significant. The fact that this significant difference is observed at the 4th hour values, reveals the importance of these parameters in early diagnosis. Thanks to the economic and fast results of thiol parameters, it is thought that new studies to be added to the literature can lead to the diagnosis of mesenteric ischemia.
Keywords: Mesenteric ischemia, thiol, lactate, early diagnosis

Mezenter Ýskeminin Erken Tanýsýnda Thiol, CRP ve Laktat'ýn Öneminin Araþtýrýlmasý: Hayvan Deneyi Modeli

Giriþ ve Amaç: Akut mezenterik iskemi özellikle yaþlý popülasyonda görülmektedir. Ortalama yaþam ömrünün arttýðý günümüz dünyasýnda giderek artan bir insidansa sahiptir. Erken taný morbidite ve mortaliteyi azaltan en önemli etken olup, erken tanýyý saðlamada sensitivitesi ve spesifitesi yüksek bir belirteç halen bulunmamaktadýr. Biz bu çalýþmamýzda thiol ile mevcut aktif kullanýlan belirteçler olan C reaktif protein ve laktat ile karþýlaþtýrarak mezenterik iskemi erken tanýsýnda daha sensitif ve spesifik bir serum belirteci bulmayý amaçladýk.
Gereç ve Yöntem: Çalýþmamýzda 32 adet 10-12 haftalýk 250-300 gr aðýrlýðýnda Wistar Albino erkek rat kullanýldý. 32 rat bir tanesi kontrol olmak üzere 4 gruba ayrýldý. Diðer 3 grubun superior mezenter arteri baðlandý. Bir gruptan 2, ikinci gruptan 4, üçüncü gruptan 6 saat sonra kan örneði alýnarak ratlar sakrifiye edildi. Sakrifiye edilen deneklerde mezenter iskemi ve düzeyi gözlendi. Alýnan örnekler uygun koþullarda ayrýþtýrýlarak biyokimyasal olarak analiz edildi.
Bulgular: CRP iskemi süresi arttýkça yükselmekle beraber bu yükseliþ istatistiksel olarak anlamsýz bulunmuþtur (p>0, 05). Laktattaki deðiþimler ise istatistiksel olarak anlamlý bulunmuþtur (p<0, 05). Total ve native thiol deðerlerinin deðiþimleri arasýndaki fark istatistiksel olarak anlamlý bulunmuþtur (p<0, 05).
Sonuç: Akut mezenterik iskeminin erken tanýsýnda CRP non spesifik bir parametre olmakla beraber laktat çalýþmamýzda da görüldüðü gibi önemini korumaktadýr. Total thiol ve native thiol deðiþim farklarý istatistiksel olarak anlamlý bulunmuþtur. Bu anlamlý farkýn kendini 4. saat deðerlerinde göstermesi erken tanýda bu parametrelerin önemini gözler önüne sermektedir. Thiol parametrelerinin ucuz ve hýzlý sonuçlanmasý sayesinde literatüre eklenecek yeni çalýþmalar ile mezenter iskemi tanýsýnda yol alýnabileceði düþünülmektedir.