Deneysel olarak karbonmonoksit zehirlenmesi oluşturulan ratlarda miyokard hasarının şiddeti ile B tipi natriüretik peptid ve kardiyak troponin I düzeyleri arasındaki ilişki
The relationship between the severity of myocardial injury and the levels of B type natriuretic peptide and cardiac troponin I in rats experimentally exposed to carbon monoxide
Yazar: MURAT YÜCEL
Danışman: DOÇ.DR. LEVENT AVŞAROĞULLARI
Erciyes Üniversitesi / Tıp Fakültesi / Acil Tıp Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2006
Konu: İlk ve Acil Yardım = Emergency and First Aid

Özet:
zehirlenme grupları) cTnI düzeyleri yüksek saptandı ancak sadece grup 4 ilearalarındaki fark istatistiksel olarak anlamlı bulundu (p<0,05). Grup 3 ve 4'de cTnIdüzeyleri ile BNP düzeyleri arasında istatistiksel olarak pozitif yönde ilişki saptandı(R:0,76 - p<0,05 - n:38).Sonuç: Akut, şiddetli CO zehirlenmesinde BNP seviyeleri yükselmektedir.Akut, şiddetli CO zehirlenmesinde BNP seviyeleri cTnI'ya göre daha erkenyükselmektedir. Miyokard hasarını gösteren cTnI yüksekliği saptanan vakaların BNPseviyeleri de yüksektir. BNP akut CO zehirlenmesinde miyokard hasarını veşiddetini gösterebilir.Anahtar kelimeler: Karbonmonoksit zehirlenmesi, B tipi natriüretik peptid,kardiyak troponin I.vi

Abstract:
THE RELATIONSHIP BETWEEN THE SEVERITY OFMYOCARDIAL INJURY AND THE LEVELS OF B TYPENATRIURETIC PEPTIDE AND CARDIAC TROPONIN IIN RATS EXPERIMENTALLY EXPOSED TOCARBON MONOXIDEABSTRACTAim: In this study, our purpose was to determine whether plasma B typenatriuretic peptide (BNP) level can be useful or not in determining the severity ofmyocardial injury formed by carbon monoxide (CO) poisoning and to compareplasma BNP level with serum cardiac troponin I (cTnI) level.Materials and methods: In the study, 46 female Vistar Albino rats weighing210-235 gr were used. Rats were divided into four groups, one sham group and threepoisoning groups. Groups included 10 rats in sham group and 12 rats in poisoninggroups. The rats to be poisoned with CO were placed in an anesthesia chamber. Themixture of pure CO and air was injected with 3 lt/min speed for 60 minutes toprovide 3000 ppm CO concentration in the chamber. After this period rats weretaken out of the chamber into normal atmosphere. The rats which died during or afterthe poisoning were excluded from the study. Blood samples of sham group werecollected both to measure carboxyhemoglobin (COHb), BNP and cTnI levels and tocompare with poisoning groups. Blood samples of poisoning groups were collectedat the 1st, 6th and 12th hours after poisoning. After biochemical procedures, findingswere analysed statistically and compared with each other.viiResults: Eight rats which died in poisoning groups were excluded from thestudy and 38 rats out of 46 were evaluated. COHb levels were rather high in Group 2(1st hour poisoning group) compared to Group 1 (Sham group) and the differencebetween groups was statistically significant (p<0,05). BNP levels were high in allpoisoning groups compared to Group 1 and the difference between them wasstatistically significant (p<0,05). cTnI levels were high in Groups 3 and 4 (6th and12th hours poisoning groups) compared to Groups 1 and 2 but only Group 4 hadstatistically significant difference (p<0,05). A statistically positive relation wasestablished between BNP and cTnI levels in Groups 3 and 4 (R:0,76 - p<0,05 - n:38).Conclusion: It was found that BNP levels increased in acute, severe COpoisoning. It was also seen that BNP levels increased earlier than cTnI levels inacute, severe CO poisoning. BNP levels of the cases which were determined to haveincreased cTnI levels showing myocardial injury increased as well. BNP can showmyocardial injury and its severity in acute CO poisoning.Key words: Carbon monoxide poisoning, B type natriuretic peptide, cardiactroponin Iviii