Kronik obstrüktif akciğer hastalıklı bireylerde surfaktan a,b,c,d proteinlerinin ataklar ve solunum fonksiyonları ile ilişkisi
The relationship between surfactant proteins a, b, c, d and attacks, respiratory functions in patients with chronic obstructive pulmonary disease
- Tez No: 309990
- Danışmanlar: PROF. DR. AHMET İLVAN
- Tez Türü: Tıpta Uzmanlık
- Konular: Göğüs Hastalıkları, Chest Diseases
- Anahtar Kelimeler: COPD, Surfactant Protein A, Respiration Function Tests
- Yıl: 2012
- Dil: Türkçe
- Üniversite: Mersin Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Göğüs Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 58
Özet
Son yıllarda kronik obstrüktif akciğer hastalığında (KOAH) sistemik inflamasyon ve akciğer fonksiyonları konusunda giderek artan yayınlar mevcuttur. İnflamatuar süreçte surfaktan proteinlerinin (SP) seviyesinde artış olmaktadır. SP'lerin, kapsüllü bakterilerin bağlanması, alveolar makrofajların antibakteriyel etkisinin kuvvetlendirilmesi, virusların opsonizasyonu ve inflamatuar cevabın düzenlenmesinde de etkileri bulunmaktadır.Bu tez çalışmasında, SP'lerinin KOAH'da değişimini göstermek, ataklar ve solunum fonksiyonları ile ilişkisini araştırmak amaçlanmıştır.Çalışmamıza; Kasım 2010 - Kasım 2011 tarihleri arasında Mersin Üniversitesi Araştırma ve Uygulama Merkezi Göğüs Hastalıkları Anabilim Dalı polikliniğine başvuran KOAH atak tanısı konan 30 hasta alınmıştır. Bu hastaların anamnez, fizik muayene, SFT, AKG'ları, rutin biyokimyasal testleri, SP-A, B, C, D düzeyleri, son 1 yıldaki atak sayıları ve atak şiddetleri değerlendirilmiştir.Hastaların KOAH atağı için gerekli tedavileri yeterli süre uygulandıktan sonra şikayet, belirti ve bulguları atak öncesi dönem seviyesi elde edilince SFT, AKG'ları tekrar değerlendirilmiş ve SP'ler için tekrar kan alınmıştır.Hastaların stabil dönem SP-A, C, D değeri, kontrol grubu olgularına göre anlamlı derecede yüksek bulundu (sırasıyla p değerleri
Özet (Çeviri)
In recent years there have been increasing number of publications in COPD concerning systematic inflammation and lung functions. Surfactant proteins level is increased in inflammatory process. There are also affects of surfactant proteins on binding of encapsulated bacteria, alveolar macrophages, the reinfforcement of anti-bacterial effect, opsonizasyon of viruses and regulation of inflammatory response.In this study, showing variation of surfactant proteins in COPD and investigation of relationship between surfactant proteins and attacks, respiratory functions are aimed.In our study, between November 2010 and November 2011, 30 COPD patients identified with COPD attacks consulted to Mersin University Research and Application Center Department of Chest Diseases Clinic are take into consideration. In this patients, medical histories, physical examinations, pulmonary function tests, arterial blood gases, routine biochemical tests, surfactant A, B, C, D proteins, the number of episodes in last year and severity of attacks were evulated.After application of required treatments in sufficient period, pulmonary function tests and arterial blood gases were evulated again when symptoms, complaints and evidences obtained in the same level with the period before attacks. Additonally the blood was taken again for surfactant proteins.Individuals in the control group, medical history was investigated and physical examination and pulmonary function tests were applied, venous blood was taken for the measurement of surfactant proteins.The stabil period surfactant proteins A, C, D values were observed significantly higher than control groups. The surfactant proteins levels which obtained in attack period were observed higher with respect to control group.The surfactant proteins values of patients in attack period was observed as meaningful increasement.The CRP values in stable and attack period were higher with respect to control group; the attack period CRP values were meaningfully higher with respect to stable period.The relationship of surfactant proteins with disease severity and attack intensity were not statically meaningful.Spirometry values in stable period with no correlation was found between any of surfactant proteins. Negative correlation was found between attack period FEF25-75 and surfactant protein B values. Surfactant proteins combined attack and stable period, the correlation between Spirometry values were evaluated and only a weak negative correlation with the surfactant protein C was observed. When the results of patient group and contol group were evaluated together, stronger correlations were obtained between all surfactant proteins and spirometry values.No significant correlations were observed between stable period PO2 value and surfactant proteins. Important negative correlations were seen for PCO2 and four surfactant proteins.When stable and attack period evidence were taken together, weak but meaningful correlation was observed between PO2 values and all surfactant proteins, meaningful correlation was only seen between PCO2 and surfactant protein B.CRP levels were higher during attacks increased in all surfactant proteins increase and this increase was correlated with surfactant proteins. All evidence were taken together, medium correlation was obtained between CRP and surfactant protein B, higher correlations were seen between CRP and others.Blood surfactant protein A, C, D increased in COPD, four surfactant proteins also increased in attack and as markers of inflamation in COPD exacerbation concluded that the use may be beneficial.
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