Beiraghi-Toosi Arash, Askarian Roya, Sadrabadi Haghighi Faezeh, Safarian Mohammad, Kalantari Fereshteh, Hashemy Seyed Isaac
Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Plastic Surgery, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Emerg (Tehran). 2018;6(1):e54. Epub 2018 Aug 31.
Several studies have shown the role of oxidative stress in pathophysiology of burn injuries. This study aimed to evaluate the changes of oxidant-antioxidant levels during the week following burn injuries and its correlation with grade of burn.
In this prospective cross-sectional study, changes of total glutathione, reduced glutathione (GSH), oxidized GSH (GSSG), GSH/GSSG ratio, as well as Pro-oxidant-antioxidant balance (PAB) were investigated on the 1, 2 and 7 days of admission in patients with > 15 % burns.
40 patients with the mean age of 21.1 ± 14.5 were studied (47.5% male). More than 50% of patients were in the 18 - 55 years age range and over 70% had 20% - 60% grade of burn. Total serum glutathione level and GSH had significant decreasing trends (P < 0.001) and GSSG and GSH/GSSG ratio had increasing trends (p < 0.001). No significant correlation was observed between serum GSH level and the total body surface area (TBSA) of burn injury (r = 0.047; p = 0.779). The evaluation of PAB and its correlation with TBSA showed a significant and direct association between them on the 1 (coefficient = 0.516; p = 0.001), 2 (coefficient = 0.62; p <0.001), and 3 (coefficient = 0.471; p = 0.002) day of follow up.
According to this study, the redox perturbation occurred in burn injury which was measured and proved by decreased GSH/GSSG ratio as well as the shift of PAB in favour of oxidants. Besides, since PAB positively correlated with the severity of dermal damage, it might suggest the application of antioxidants as a part of therapeutic protocol for which the dosage should be proportionate to the surface area of the damaged skin.
多项研究表明氧化应激在烧伤病理生理学中所起的作用。本研究旨在评估烧伤后一周内氧化-抗氧化水平的变化及其与烧伤程度的相关性。
在这项前瞻性横断面研究中,对烧伤面积大于15%的患者在入院第1、2和7天调查其总谷胱甘肽、还原型谷胱甘肽(GSH)、氧化型谷胱甘肽(GSSG)、GSH/GSSG比值以及促氧化剂-抗氧化剂平衡(PAB)的变化。
研究了40例平均年龄为21.1±14.5岁的患者(47.5%为男性)。超过50%的患者年龄在18 - 55岁之间,超过70%的患者烧伤程度为20% - 60%。血清总谷胱甘肽水平和GSH呈显著下降趋势(P < 0.001),GSSG和GSH/GSSG比值呈上升趋势(p < 0.001)。未观察到血清GSH水平与烧伤总面积(TBSA)之间存在显著相关性(r = 0.047;p = 0.779)。对PAB及其与TBSA的相关性评估显示,在随访第1天(系数 = 0.516;p = 0.001)、第2天(系数 = 0.62;p <0.001)和第3天(系数 = 0.471;p = 0.002),它们之间存在显著的正相关。
根据本研究,烧伤时发生了氧化还原紊乱,这通过GSH/GSSG比值降低以及PAB向氧化剂方向的偏移得以测量和证实。此外,由于PAB与皮肤损伤严重程度呈正相关,这可能提示将抗氧化剂作为治疗方案的一部分应用,其剂量应与受损皮肤的表面积成比例。