DISCUSSION
PTE is one of the leading causes of death because of its high morbidity
and mortality. If untreated, the mortality rate of up to 30% can be
reduced to 3-8% as because of early diagnosis and treatment. Despite
technological advances in diagnosis, its symptoms, radiological and
laboratory findings are not specific [16, 17]. The incidence of
pulmonary embolism increases with age [5]. In our study, we found
the mean age of the patient group to be 56.87 ± 16.30 years.
Thiols are sulfur analogs of alcohols, which are formed by bonding a
sulfur and hydrogen atom to the carbon atom, containing sulfhydryl (-SH)
groups. Albumin and other proteins make up the most of the plasma thiol
pool, while the remaining small part is low molecular weight thiols such
as cysteine, cysteinyl, glycine, glutathione, homocysteine and
gamma-glutamylcysteine. Disulphide (RS-SR) bonds are formed when thiols
(R-SH) undergo an oxidation reaction by various oxidants. The disulphide
bonds formed can be reduced back to the thiol groups, thus maintaining
the dynamic thiol / disulphide balance [7]. There are some studies
that show that dynamic thiol disulphide balance is affected in many
diseases [8-11, 18]. In the study of Parlak et al. investigating the
relationship between thiol/disulphide balance status and HDL cholesterol
level with pulmonary embolism, it was reported that native thiol, total
thiol and HDL-C values were significantly lower in the patient group
compared to the control group. It was reported that % disulphide/native
thiol was significantly lower in the control group compared to the
patient group. It was reported that there was no significant difference
in disulphide level between the patient and the control group [19].
Topuz et al. In the study investigating the prognostic significance of
thiol disulphide homeostasis in patients with acute pulmonary
thromboembolism, it was found that the mean native thiol level was lower
in the pulmonary thromboembolism group, the disulphide level and the %
disulphide/total thiol ratio was higher than the control group. Among
the limitations of this study, it was stated that the patients had some
comorbidities such as diabetes mellitus and atherosclerosis, which can
change the thiol disulphide balance
[20].
There are a few studies investigating thiol/disulphide balance in PTE
patients. Determination of dynamic thiol/disulphide status in diseases
where oxidative stress plays a major role in pathogenesis would be
important. In our study, we found that native thiol, total thiol, native
thiol/total thiol levels in the patient group were significantly lower
than the control group. We found that the disulphide, disulphide/native
thiol, disulphide/total thiol values were significantly higher in the
patient group compared to the control group. The result of native thiol,
total thiol and disulphide/native thiol in our study is in parallel with
the result of both Parlak et al. and Topuz et al. study. However,
although Parlak et al. did not find a significant difference in the
level of disulphide between the groups, we found significantly higher
disulphide levels in the patient group in our study. In addition,
although some comorbidities that would change the thiol disulphide
balance were not excluded in the study conducted by Topuz et al., it
excluded them from our study. The results we got in our study show that
there is a significant difference not only between the patient and
control groups, but also between the subgroups of the patients.