Van Tıp Dergisi (Nov 2017)
Adenotonsiller Hipertrofi Olan Çocuklarda Adenotonsillektominin N-Terminal Pro-Beyin Natriüretik Peptid (NT-ProBNP) Düzeylerine Etkileri
Abstract
INTRODUCTION: Adenotonsillar hypertrophy (ATH) is the most common cause for obstructive sleep apnea syndrome (OSAS) and adenotonsillectomy is used in treatment. Children with OSAS experience cardiovascular complications. N-terminal pro-brain natriuretic peptide (NT-proBNP) is one of the critical markers used for cardiovascular diseases. The present study aimed to determine the effects of adenotonsillectomy on NT-proBNP levels in patients with ATH. METHODS: Children with ATH, who were admitted with the complaints of snoring, mouth breathing and breathing pauses during sleep, were included. Measurements of arterial oxygen saturation (SaO2), complete blood cell count, routine biochemical blood tests, chest radiography, electrocardiography, and a complete ear, nose, throat examination were performed. Upper airway obstruction (Grade I, II, III or IV) and snoring (mild, moderate, and severe) were graded. NT-proBNP level was measured quantitatively by electrochemiluminescence method. Adenotonsillectomy was performed by curettage and cold dissection methods under general anesthesia. RESULTS: The study included 25 patients with ATH (mean age, 8.5+-2.9 years; 17 boys). Snoring or apnea was not observed in any of the patients at the post-operative 6 month. The median (min-max) pre- and post-operative NT-proBNP levels were 10.01 pg/mL (3.08-63.58 pg/mL) and 7.13 pg/mL (3.01-91.75 pg/mL), respectively and the difference was significant. There were no significant differences among the subgroups of gender, pre-operative snoring, pre-operative apnea, tonsil size, and adenoid size regarding the difference of NT-ProBNP level between the post- and pre-operative periods. DISCUSSION AND CONCLUSION: Adenotonsillectomy provided airway patency, and thereby led to an improvement in unfavorable effects on cardiovascular system.
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