Sepsis hastalarında tiyol/disülfid homeostaz değişikliklerinin ve prognoz ile ilişkisinin araştırılması

Year 2024, Volume: 29 Issue: 1, 13 - 18, 27.01.2024

Semiha Solak Grassie , Ş. Deniz Atakent , Havva Şahin Kavaklı , Filiz Banu Çetinkaya Ethemoğlu , Ahmet Rıfat Balık , Özcan Erel

https://doi.org/10.21673/anadoluklin.1248015

Abstract

Amaç: Sepsis hayatı tehdit eden en yaygın sendromdur. Oksidatif stres sepsis patogenezinde rol oynayan mekanizmalardan biridir. Tiyoller antioksidan tamponlardır. Tiyol parametrelerindeki değişiklikler, oksidatif dengedeki değişiklikleri ifade eder. Bu çalışmada sepsis hastalarında tiyol homeostazındaki değişiklikleri araştırmayı amaçladık.

Yöntemler: Bu çalışmaya 99 hasta dâhil edildi: 53 hasta (Yoğun Bakım Ünitesi’inde sepsis tanısı konulan) ve 46 kontrol. Sepsis hastaları tanı, takip ve hastalık şiddetlerine göre iki gruba ayrıldı: sepsis ve septik şok. Hasta ve kontrollerde total tiyol ve native tiyol seviyeleri ölçüldü. Disülfit seviyeleri hesaplandı. Tiyol parametreleri hasta ve kontrol grupları, sepsis ve septik şok, ölen ve hayatta kalan gruplar arasında karşılaştırıldı.

Bulgular: Sepsis hastalarında kontrollere göre disülfit/native tiyol ve disülfit/total tiyol oranları belirgin daha yüksek (p: <0.001, p: <0.001), native tiyol ve total tiyol seviyeleri daha düşüktü (p: <0.001, p: 0.00). Sepsis grubuyla karşılaştırıldığında septik şok hastalarında disülfit düzeyi daha yüksek p: <0.001, native tiyol ve total tiyol düzeyleri daha düşüktü (p: <0.001, p: 0.009). Hayatta kalan hastalardan alınan sonuçlar, ölen hastalardan istatistiksel olarak farklılık göstermedi.

Sonuç: Tiyol homeostaz parametrelerindeki farklılıklar, sepsis hastalarının kontrollere kıyasla daha yüksek oksidatif strese sahip olduğunu gösterdi. Oksidatif stres değişiklikleri hastalık şiddeti ile paraleldi. Sepsis hastalarına kıyasla septik şok hastalarında oksidatif stres daha yüksekti. Sepsiste birçok yeni biyobelirteç olmasına rağmen tanı hala bir sorundur. Tiyol parametrelerinin ölçülmesi ve değerlendirilmesi sepsis tanı ve takibine katkı sağlayacaktır.

Keywords

Oksidatif stress, prognoz, septik şok, sepsis

Investigation of thiol/disulfide homeostasis changes and their relationship with prognosis in sepsis patients

Abstract

Aim: Sepsis is the most common life-threatening syndrome. Oxidative stress is one of the mechanisms involved in the pathogenesis of sepsis. Thiols are antioxidant buffers. Changes in thiol parameters refer to changes in oxidative balance. In this study, we aimed to investigate thiol homeostasis changes in sepsis patients.

Methods: We included 99 patients (53 patients diagnosed with sepsis in the Intensive Care Unit and 46 controls). Sepsis patients were divided into two groups based on their diagnosis, follow-up, and disease severity: sepsis and septic shock. Total thiol and native thiol levels were analyzed in the patients and controls. Disulfide levels were calculated. The thiol parameters were compared between the patient and control groups, sepsis and septic shock, mortality, and survivor groups.

Results: In sepsis patients, the disulfide/native thiol and disulfide/total thiol rates were significantly higher (p <0.001; <0.001), and the native thiol and total thiol levels were lower (p <0.001; <0.001) than controls. Compared to the sepsis group, the disulfide level was higher p:0.001, and native thiol and total thiol levels were lower (p <0.001; 0.009) in the septic shock patients. The results from patients who survived showed no statistical difference from those patients who died.

Conclusion: The differences in thiol homeostasis parameters showed that sepsis patients had higher oxidative stress compared to the controls. The oxidative stress changes were parallel to the disease severity. The septic shock patients had higher oxidative stress compared to the sepsis patients. Diagnosis is still a problem despite the many new biomarkers for sepsis. Analyzing thiol parameters and assessing them will contribute to the diagnosis and follow-up of sepsis patients.

Keywords

Oxidative stress, prognosis, septic shock, sepsis

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