Crimi Ettore, Sica Vincenzo, Williams-Ignarro Sharon, Zhang Haibo, Slutsky Arthur S, Ignarro Louis J, Napoli Claudio
Department of Anesthesiology and Critical Care Medicine, University of Eastern Piedmont, 28100 Novara, Italy.
Free Radic Biol Med. 2006 Feb 1;40(3):398-406. doi: 10.1016/j.freeradbiomed.2005.10.054. Epub 2005 Nov 18.
Oxidative stress defines an imbalance in production of oxidizing chemical species and their effective removal by protective antioxidants and scavenger enzymes. Evidence of massive oxidative stress is well established in adult critical illnesses characterized by tissue ischemia-reperfusion injury and by an intense systemic inflammatory response such as during sepsis and acute respiratory distress syndrome. Oxidative stress could exacerbate organ injury and thus overall clinical outcome. We searched MEDLINE databases (January 1966 to June 2005). For interventional studies, we accepted only randomized trials. Several small clinical trials have been performed in order to reduce oxidative stress by supplementation of antioxidants alone or in combination with standard therapies. These studies have reported controversial results. Newer large multicenter trials with antioxidant supplementation should be performed, considering administration at an early stage of illness and a wider population of critically ill patients.
氧化应激是指氧化化学物质的产生与保护性抗氧化剂和清除酶对其有效清除之间的失衡。在以组织缺血再灌注损伤以及强烈的全身炎症反应（如脓毒症和急性呼吸窘迫综合征期间）为特征的成人危重病中，大量氧化应激的证据已得到充分证实。氧化应激会加剧器官损伤，进而影响整体临床结局。我们检索了MEDLINE数据库（1966年1月至2005年6月）。对于干预性研究，我们仅纳入随机试验。已经开展了多项小型临床试验，旨在通过单独补充抗氧化剂或与标准疗法联合使用来减轻氧化应激。这些研究报告的结果存在争议。考虑到在疾病早期给药以及纳入更广泛的危重病患者群体，应开展更新的补充抗氧化剂的大型多中心试验。
