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抗氧化剂对烧伤患者伤口感染发生率的影响。

Effect of antioxidants on the incidence of wound infection in burn patients.

作者信息

Sahib A S, Al-Jawad F H, Alkaisy A A

机构信息

Department of Pharmacology, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.

出版信息

Ann Burns Fire Disasters. 2010 Dec 31;23(4):199-205.

Abstract

Background. Thermal injury causes the destruction of the physical skin barrier that normally protects the body from invasion by micro-organisms and induces an immunocompromised state that predisposes burn patients to infection, sepsis, and multiple organ failure. Reactive oxygen species contribute to burn-mediated immune suppression, and as the use of antioxidants has a positive effect on immune function, this may reduce the incidence of wound infection and related complications in burn patients. Patients and methods. One hundred and eighty burn patients of either sex and different ages, suffering from burns of varying percentage, were involved in the study. They were allocated to six groups: A, B, C, D, E, and F, each of 30 patients. Groups B, C, D, E, and F were treated with antioxidants (vitamins E and C, zinc sulphate, allopurinol, melatonin, and N-acetylcysteine, respectively) while group A was treated without antioxidants, according to our hospital policy. Thirty healthy subjects (group G) were also involved in the study as a control group for comparison. In each group, serum malondialdehyde and serum glutathione levels, microbiological values, healing time, and the mortality rate were measured using standard methods. Results. Administering antioxidants to burn patients produced significant improvements in the parameters studied compared with burn patients not given antioxidants. Conclusion. The study clearly showed the beneficial effect of antioxidants in the treatment of burn patients, as evidenced by the reduced incidence of wound infection and the shortening of healing time, in addition to the lower mortality rate. It is therefore recommended to add antioxidants to the treatment list of burn patients.

摘要

背景。热损伤会破坏通常保护身体免受微生物入侵的物理皮肤屏障,并引发免疫功能低下状态,使烧伤患者易发生感染、败血症和多器官功能衰竭。活性氧会导致烧伤介导的免疫抑制,由于使用抗氧化剂对免疫功能有积极影响,这可能会降低烧伤患者伤口感染及相关并发症的发生率。

患者与方法。本研究纳入了180例不同性别、年龄各异、烧伤面积不同的烧伤患者。他们被分为六组:A组、B组、C组、D组、E组和F组,每组30例患者。根据我院的治疗方案,B组、C组、D组、E组和F组分别接受抗氧化剂治疗(分别为维生素E和C、硫酸锌、别嘌呤醇、褪黑素和N - 乙酰半胱氨酸),而A组不接受抗氧化剂治疗。另外还纳入了30名健康受试者(G组)作为对照组进行比较。在每组中,使用标准方法测量血清丙二醛和血清谷胱甘肽水平、微生物学指标、愈合时间和死亡率。

结果。与未接受抗氧化剂治疗的烧伤患者相比,给予烧伤患者抗氧化剂治疗后,所研究的各项参数均有显著改善。

结论。该研究清楚地表明了抗氧化剂在烧伤患者治疗中的有益作用,并体现在伤口感染发生率降低、愈合时间缩短以及死亡率降低上。因此,建议将抗氧化剂纳入烧伤患者的治疗方案中。

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