Dumlu Ersin Gürkan, Tokaç Mehmet, Bozkurt Birkan, Yildirim Murat Baki, Ergin Merve, Yalçin Abdussamed, Kiliç Mehmet
Department of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey.
Department of Biochemistry, Atatürk Training and Research Hospital, Ankara, Turkey.
Clinics (Sao Paulo). 2014 Dec;69(10):677-82. doi: 10.6061/clinics/2014(10)05.
To determine the serum and tissue levels of markers of impaired oxidative metabolism and correlate these levels with the histopathology and Alvarado score of acute appendicitis patients.
Sixty-five acute appendicitis patients (mean age, 31.4±12.06 years; male/female, 30/35) and 30 healthy control subjects were studied. The Alvarado score was recorded. Serum samples were obtained before surgery and 12 hours postoperatively to examine the total antioxidant status, total oxidant status, paraoxonase, stimulated paraoxonase, arylesterase, catalase, myeloperoxidase, ceruloplasmin, oxidative stress markers (advanced oxidized protein products and total thiol level) and ischemia-modified albumin. Surgical specimens were also evaluated.
The diagnoses were acute appendicitis (n = 37), perforated appendicitis (n = 8), phlegmonous appendicitis (n = 12), perforated+phlegmonous appendicitis (n = 4), or no appendicitis (n = 4). The Alvarado score of the acute appendicitis group was significantly lower than that of the perforated+phlegmonous appendicitis group (p = 0.004). The serum total antioxidant status, total thiol level, advanced oxidized protein products, total oxidant status, catalase, arylesterase, and ischemia-modified albumin levels were significantly different between the acute appendicitis and control groups. There was no correlation between the pathological extent of acute appendicitis and the tissue levels of the markers; additionally, there was no correlation between the tissue and serum levels of any of the parameters.
The imbalance of oxidant/antioxidant systems plays a role in the pathogenesis acute appendicitis. The Alvarado score can successfully predict the presence and extent of acute appendicitis.
测定氧化代谢受损标志物的血清和组织水平，并将这些水平与急性阑尾炎患者的组织病理学及阿尔瓦拉多评分相关联。
对65例急性阑尾炎患者（平均年龄31.4±12.06岁；男/女为30/35）和30名健康对照者进行研究。记录阿尔瓦拉多评分。在手术前及术后12小时采集血清样本，检测总抗氧化状态、总氧化状态、对氧磷酶、刺激后对氧磷酶、芳基酯酶、过氧化氢酶、髓过氧化物酶、铜蓝蛋白、氧化应激标志物（晚期氧化蛋白产物和总巯基水平）以及缺血修饰白蛋白。同时对手术标本进行评估。
诊断结果为急性阑尾炎（n = 37）、穿孔性阑尾炎（n = 8）、蜂窝织炎性阑尾炎（n = 12）、穿孔合并蜂窝织炎性阑尾炎（n = 4）或无阑尾炎（n = 4）。急性阑尾炎组的阿尔瓦拉多评分显著低于穿孔合并蜂窝织炎性阑尾炎组（p = 0.004）。急性阑尾炎组与对照组之间的血清总抗氧化状态、总巯基水平、晚期氧化蛋白产物、总氧化状态、过氧化氢酶、芳基酯酶和缺血修饰白蛋白水平存在显著差异。急性阑尾炎的病理程度与标志物的组织水平之间无相关性；此外，任何参数的组织水平与血清水平之间也无相关性。
氧化/抗氧化系统失衡在急性阑尾炎的发病机制中起作用。阿尔瓦拉多评分能够成功预测急性阑尾炎的存在及程度。
