Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Kondenzat izdaha kao komplementarna metoda u dijagnostičkoj procjeni djece s astmom i djece s gastroezofagealnom refluksnom bolešću

Vlašić, Željka (2010) Kondenzat izdaha kao komplementarna metoda u dijagnostičkoj procjeni djece s astmom i djece s gastroezofagealnom refluksnom bolešću. PhD thesis, Sveučilište u Zagrebu.

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    Croatian abstract

    Cilj: Odrediti komparativne vrijednosti pH, željeza, kalcija i magnezija u kondenzatu izdaha djece s astmom, djece s GERB-om i djece kontrolne skupine. ----- Ispitanici: Ispitanici, djeca i adolescenti u dobi od 5 – 16 godina, svrstani su u tri skupine: I. djeca s umjerenom trajnom astmom, u akutnoj egzacerbaciji (N = 59), II. djeca s GERB-om (N = 75), III. kontrolna skupina djece (N = 30). ----- Metode: Kondenzat izdaha prikupljen je standardnom metodom pomoću aparata EcoScreen (Erich Jaeger GmbH, Hoechberg, Germany). Uzorak je nadslojen s argonom (protok argona od 6 Lmin-1 kroz 2 minute). Odmah su određeni pH, pO2 i pCO2 na analizatoru Ecosys II (EschweilerGmbH&Co. KG, Kiel, Germany). Uzorak je potom do analize pohranjen na -80oC. Nakon odmrzavanja određene su koncentracije željeza, magnezija i kalcija, na automatskom selektivnom analizatoru Olympus AU 400 (Olympus, Tokyo, Japan). ----- Rezultati: Smanjene vrijednosti pH u kondenzatu izdaha bolesnika s astmom u usporedbi s kontrolnom skupinom nesumnjivo su pokazale postojanje kiselog stresa u tekućini koja oblaže dišne putove, što kod bolesnika s GERB-om nije bio slučaj. Poremećaj homeostaze željeza u plućima, dokazan je i u bolesnika u akutnoj egzacerbaciji astme i u bolesnika s GERB-om, što ukazuje na dinamične promjene oksidativnih i antioksidativnih procesa unutar dišnog sustava kod tih dviju skupina bolesnika. Promijenjen odnos magnezija i kalcija u bolesnika u akutnoj egzacerbaciji astme odnosno s GERB-om u odnosu na kontrolnu skupinu ukazuje na redistribuciju tih iona između stanica mišića bronha i tekućine koja ih oblaže. ----- Zaključak: Utvrđena je dijagnostička vrijednost određivanja pH u izdahnutom konndenzatu djece u akutnoj egzacerbaciji astme, te željeza i omjera magnezij /kalcij u djece u akutnoj egzacerbaciji astme i djece s GERB-om. U patofiziologiji astme i GERB-a važnu ulogu imaju upala (kiseli stres), narušena homeostaza željeza (oksidacijski stres), te redistribucija kalcija i magnezija (bronhokonstrikcija). Promijenjene vrijednosti tih biomarkera u kondenzatu izdaha mogu biti korisni, dodatni dijagnostički pokazatelji uz uobičajeno određivanje FENO i mjerenja plućne funkcije u djece s astmom, odnosno 24-satne pH-metrije jednjaka u djece s GERB-om.

    English abstract

    Aim: to define comparative values of pH, iron, calcium and magnesium in exhaled breath condensate (EBC) of children with acute asthma exacerbation, children with gastoesophageal reflux disease (GERD) and controls. ----- Subjects:exhaled breath condensate (EBC) was collected with standard method by using an EcoScreen condenser (Erich Jaeger GmbH, Hoechberg, Germany). Each sample was submitted to argon overlining (6 Lmin-1 for 2 minutes). Right afterwards the determination of pH, pO2 and pCO2 on the Ecosys II analyzer (EschWeilerGmbH &Co. KG, Kiel, Germany) proceded. Then the EBC sample was stored at –80°C. After derfosing, the concentrations of iron, calcium and magnesium were determined on an automated selective Olympus AU 400 analyzer (Olympus, Tokyo, Japan). ----- Results: reduced values of pH in EBC of asthmatic children comparing to controls doubtlesly showed the existance of acid stress in fluid that overlines the airways, which was not the case in children with GERD. Disturbed homeostasis in lungs was proven both at patients with acute asthma exacerbation and GERD, which points out the dynamic changes between oxidative and antioxidative processes inside the respiratory system within these two groups. The altered relation between magnesium and calcium of both patients with acute asthma exacerbation and patients with GERD comparing to controls points at redistribution of these ions between the bronchii smooth muscle cells and the fluid that overlines them. ----- Conclusion: diagnostic value was found at determining pH in children with acute asthma exacerbation, then iron and magnesium/calcium ratio both in children with acute asthma exacerbation and GERD. Very important role in the pathophisiology of asthma and GERD plays the inflammation (acid stress), the disturbed homeostasis of iron (oxidative stress), and the redistribution of calcium and magnesium (bronchoconstriction). Chosen biomarkers from the EBC can complete the results of FENO and lung function measuring in children with asthma and the results of 24-hour pH-measurement in children with GERD.

    Item Type: Thesis (PhD)
    Mentor: Dodig, Slavica
    Divisions: Izvan medicinskog fakulteta
    Depositing User: Marijan Šember
    University: Sveučilište u Zagrebu
    Institution: Medicinski fakultet
    Number of Pages: 105
    Status: Unpublished
    Creators:
    CreatorsEmail
    Vlašić, Željka
    Date: 28 September 2010
    Date Deposited: 22 Oct 2010
    Last Modified: 23 Sep 2011 18:11
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/862

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