Nitrik ve hidroklorik asidin sistemik ve lokal etkileri: Sýçan modelinde deneysel çalýþma

AMAÇ: Bu çalýþmada temizlik amaçlý yaygýn olarak kullanýlan %45 nitrik asit (NHO3) ve %18’lik hidroklorik asidin (HCl) lokal ve sistemik etkileri belirlemeyi amaçladýk.
GEREÇ-YÖNTEM: Bu ileriye dönük, deneysel ve plasebo kontrollü çalýþma Akdeniz Üniversitesi hayvan laboratuvarýnda gerçekleþtirildi. %45’lik NHO3 ile %18’lik HCl plasebo ile karþýlaþtýrýldý. Solüsyonlar her biri 10 sýçandan oluþan 3 gruba aðýzdan verildi. Solüsyonlar verilmeden önceki ve sonraki pH ve kalsiyum deðerleri ölçülerek, meydana gelen metabolik deðiþiklikler izlendi. Ayrýca patolojik deðiþiklikler ile ölüm oranlarý da kaydedildi.
BULGULAR: Solüsyonlarýn verilmesinden 30 dakika sonra yapýlan ölçümlerde, HCl (Ca artýþý için p=0.007, pH’deki azalma için p=0.023) ve NHO3 (Ca artýþý için p=0.006, pH’deki azalma için p=0.001) grubunda kalsiyum seviyelerinde anlamlý olarak artýþ, pH seviyelerinde ise azalma saptandý. Ayrýca, Ca ve pH deðerlerinde deðiþiklikler açýsýndan üç grup ANOVA ile karþýlaþtýrýldýðýnda istatiksel olarak anlamlý fark bulundu. Yapýlan çoklu karþýlaþtýrmada farkýn kontrol grubundan kaynaklandýðý saptandý. Mide ve özofagusun patolojik incelemesinde gruplar arasýnda anlamlý fark bulunurken (p=0.009 (Ö) ve p=0.016 (M)), farkýn yine kontrol grubundan kaynaklandýðý saptandý (p=0.543 (Ö), p=0.244 (M) NHO3 vs HCL). Otuzuncu dakikadaki ölüm oranlarý NHO3 grubunda %20, HCl grubunda %60 ve kontrol grubunda ise %0 idi.
SONUÇ: NHO3 ve HCl alýmlarý sonrasý ciddi metabolik ve hafif lokal patolojik deðiþiklikler olabilir. Bu maddelerin alýmlarý sonrasý oluþan ölümleri engellemek için yeni çalýþmalara ihtiyaç vardýr; halk saðlýðý önlemlerinin arttýrýlmasý gerekir.

Comparison of systemic and local effects of nitric acid and hydrochloric acid: an experimental study in a rat model

BACKGROUND: We aimed to determine the local and systemic effects of widely available household cleaners, namely 45% nitric acid (NHO3), and 18% hydrochloric acid (HCl), in a rat model.
METHODS: This prospective, experimental, placebo-controlled trial was carried out in the Animal Research Laboratory of Akdeniz University hospital. Commonly available solution of 45% NHO3 and 18% HCl were tested against normal saline. Each solution was administrated orally to groups consisting of ten rats. The metabolic changes were determined by measuring the pH and calcium (Ca) levels before and after the administration of solutions. In addition, the pathological changes and mortality rates were determined for each group.
RESULTS: There was a statistically significant increase in the post-ingestion (30 minutes later) Ca levels and a decrease in the post-ingestion pH levels after the administration of test solution in the NHO3 (p=0.006 for Ca increase, p=0.001 for pH decrease) and HCl (p=0.007 for Ca increase, p=0.023 for pH decrease) groups. There was also a statistically significant difference between groups for Ca increase (p=0.000) and pH decrease (p=0.006). In post hoc analysis, the difference between the groups was found to be originated from the placebo group. In the pathological evaluation of esophagus and stomach, there was a statistically significant difference between groups (p=0.009 (E) and p=0.016 (S)) and the difference was found to be originated from the control group (p=0.543 (E), p=0.244 (S) for NHO3 and HCl). The 30-minute mortality rates were 0,2 in the NHO3 group, 0,6 in the HCl group and 0 in the control group.
CONCLUSION: Serious metabolic and mild local pathological changes can occur after the ingestion of household NHO3 and HCl solutions. Further studies should be performed to elucidate the causes of death following oral ingestion of these compounds and appropriate public health warnings should be taken.