Department of Orthopedic Surgery, Taibah University, KSA.
Hum Exp Toxicol. 2011 Jun;30(6):435-42. doi: 10.1177/0960327110374203. Epub 2010 Jun 9.
It is well known that bone markers (e.g. osteocalcin and alkaline phosphatase) play a significant role in healing of bone fractures, whereas oxidative stress delay such healing. The present study aimed to investigate the effect of a mixture of antioxidants (vitamins A, C, E, and selenium) on oxidative stress parameters, and the levels of bone healing markers in the plasma of male patients following fixative surgery of long bones. Antioxidant tablets (300 µg vitamin A, 10 mg vitamin E, 60 mg vitamin C, and 75 µg selenium) were administered to groups 3 and 4 (10 patients in each) for 1 and 2 weeks, respectively, in addition to the regular postoperative treatment. Groups 1 (25 patients) and 2 (10 patients) received the regular post-operative treatment consisting of intravenous (I.V.) second generation of cephalosporin 1000 mg/day for 3 days, oral diclofenac 50 mg, and paracetamol 500 mg twice daily for 15 days. Osteocalcin level and alkaline phosphatase activity as well as antioxidant enzymes superoxide dismutase (SOD), glutathione reductase (GR), as well as glutathione (GSH), and thiobarbituric acid reactive substances (TBARS) as indices of oxidative stress, were determined in the plasma of all patients after 1 or 2 weeks of long-bone fixative surgery. The results revealed that osteocalcin level and the activity of alkaline phosphatase were markedly increased in the plasma of patients who received antioxidants for 2 weeks. In addition, after 1 and/or 2 weeks, the levels of TBARS were significantly lower in the antioxidant-treated patients compared with those who did not receive antioxidants. On the other hand, the activities of SOD and GR were markedly elevated in plasma of patients who received antioxidants after 1 or 2 weeks compared with patients who received regular therapy. Moreover, the level of plasma GSH was markedly increased only after 2 weeks in patients who received antioxidants. It is concluded that administration of antioxidant vitamins A, E, and C in addition to selenium could accelerate bone healing after long-bone fixative surgery. Therefore, antioxidants should be considered in designing therapeutic protocols in post-operative bone surgery.
众所周知，骨标志物（如骨钙素和碱性磷酸酶）在骨折愈合中起着重要作用，而氧化应激会延迟这种愈合。本研究旨在探讨抗氧化剂混合物（维生素 A、C、E 和硒）对男性患者长骨固定手术后血浆中氧化应激参数和骨愈合标志物水平的影响。抗氧化剂片剂（300μg 维生素 A、10mg 维生素 E、60mg 维生素 C 和 75μg 硒）分别给予第 3 组和第 4 组（每组 10 例）1 周和 2 周，除了常规的术后治疗。第 1 组（25 例）和第 2 组（10 例）接受常规术后治疗，包括静脉（I.V.）第二代头孢菌素 1000mg/天 3 天，口服双氯芬酸 50mg，扑热息痛 500mg 每天 2 次 15 天。在长骨固定手术后 1 或 2 周，所有患者的血浆中均测定骨钙素水平和碱性磷酸酶活性以及抗氧化酶超氧化物歧化酶（SOD）、谷胱甘肽还原酶（GR）以及谷胱甘肽（GSH）和硫代巴比妥酸反应物质（TBARS）作为氧化应激指标。结果表明，接受抗氧化剂治疗 2 周的患者血浆中骨钙素水平和碱性磷酸酶活性明显升高。此外，在第 1 或第 2 周后，抗氧化剂治疗患者的 TBARS 水平明显低于未接受抗氧化剂治疗的患者。另一方面，在第 1 或第 2 周接受抗氧化剂治疗的患者的血浆中 SOD 和 GR 的活性明显升高。此外，仅在接受抗氧化剂治疗的患者中，血浆 GSH 水平在第 2 周后明显升高。结论：在长骨固定手术后，补充维生素 A、E 和 C 以及硒等抗氧化剂可以加速骨愈合。因此，在设计术后骨外科治疗方案时应考虑抗氧化剂。
