Kim Jae Seong, Kwon Woon Yong, Suh Gil Joon, Kim Kyung Su, Jung Yoon Sun, Kim Sung Hee, Lee So Eun
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
J Surg Res. 2016 Jan;200(1):298-307. doi: 10.1016/j.jss.2015.07.044. Epub 2015 Aug 5.
Our aim was to investigate whether plasma glutathione reductase (GR) activity is well correlated with the erythrocyte-reduced glutathione (GSH)/glutathione disulfide (GSSG) ratio and is associated with the mortality of septic shock.
This study was conducted on male Sprague-Dawley rats and patients admitted to the intensive care unit with septic shock. To induce endotoxemia in rats, vehicle or lipopolysaccharide (LPS) at dosages of 5 or 10 mg/kg were injected into a tail vein. Animals were then euthanized 6 h post-LPS. Based on the 28-d mortality, the enrolled patients were divided into the survivors and nonsurvivors. We obtained blood samples from patients at admission (0 h) and 24 h after admission to the intensive care unit.
In endotoxemic rats, the erythrocyte GSH/GSSG ratio, erythrocyte GR activity, and plasma GR activity in the 10 mg/kg of LPS group were lower than those in the sham and 5 mg/kg of LPS groups. In patients with septic shock, decrease in plasma GR activity at 24 h was independently associated with an increase in 28-d mortality (odds ratio, 0.828; 95% confidence interval, 0.690-0.992, P = 0.041). Plasma GR activity was correlated with erythrocyte GR activity (Spearman ρ = 0.549, P < 0.001) and the erythrocyte GSH/GSSG ratio (rho = 0.367, P = 0.009) at 24 h.
Plasma GR activity was well correlated with erythrocyte GR activity and the erythrocyte GSH/GSSG ratio, and a decrease in plasma GR activity was associated with an increase in the mortality of septic shock patients.
我们的目的是研究血浆谷胱甘肽还原酶（GR）活性是否与红细胞还原型谷胱甘肽（GSH）/氧化型谷胱甘肽（GSSG）比值密切相关，以及是否与脓毒性休克的死亡率相关。
本研究对雄性Sprague-Dawley大鼠和入住重症监护病房的脓毒性休克患者进行。为诱导大鼠内毒素血症，将载体或剂量为5或10mg/kg的脂多糖（LPS）注入尾静脉。然后在注射LPS后6小时对动物实施安乐死。根据28天死亡率，将纳入的患者分为存活者和非存活者。我们在患者入院时（0小时）和入住重症监护病房24小时后采集血样。
在内毒素血症大鼠中，10mg/kg LPS组的红细胞GSH/GSSG比值、红细胞GR活性和血浆GR活性低于假手术组和5mg/kg LPS组。在脓毒性休克患者中，24小时时血浆GR活性降低与28天死亡率增加独立相关（比值比，0.828；95%置信区间，0.690-0.992，P = 0.041）。24小时时血浆GR活性与红细胞GR活性（Spearman ρ = 0.549，P < 0.001）和红细胞GSH/GSSG比值（ρ = 0.367，P = 0.009）相关。
血浆GR活性与红细胞GR活性和红细胞GSH/GSSG比值密切相关，血浆GR活性降低与脓毒性休克患者死亡率增加相关。
