Hsiao Sheng-Yuan, Kung Chia-Te, Su Chih-Min, Lai Yun-Ru, Huang Chin-Cheng, Tsai Nai-Wen, Wang Hung-Chen, Cheng Ben-Chung, Su Yu-Jih, Lin Wei-Che, Chiang Yi-Fang, Lu Cheng-Hsien
Department of Emergency Medicine.
Department of Neurology.
Medicine (Baltimore). 2020 Jun 26;99(26):e20872. doi: 10.1097/MD.0000000000020872.
Oxidative stress has been shown to reflect on the development of sepsis and disease severity. In the present study, we evaluated the effects of increased levels of oxidative stress and decreased antioxidant coactivity in patients with sepsis, and the importance of oxidative stress on treatment outcomes.
Biomarkers of oxidative stress (thiobarbituric acid-reactive substances [TBARS]) and antioxidant capacity (glutathione peroxidase [GPx] and glutathione content [thiol]) were prospectively evaluated along with biochemical and clinical data in 100 patients with sepsis on days 1, 4, and 7 after admission.
The TBARS level of the non-survivor group was significantly higher than that of the survivor group on day 1 and day 4 and negatively correlated with thiol upon admission. However, thiol was positively correlated with lactate concentration. The TBARS and lactate levels upon admission were independent predictors of fatality.
We conclude that a TBARS cut-off value of 18.30 μM can be used to predict fatality, and an increase in the TBARS concentration by 1 μM will increase the fatality rate by 0.94%. In the panel of biomarkers, the TBARS assay can be considered as a prognostic biomarker for the treatment of patients with sepsis.
氧化应激已被证明与脓毒症的发生发展及疾病严重程度相关。在本研究中，我们评估了脓毒症患者氧化应激水平升高和抗氧化协同活性降低的影响，以及氧化应激对治疗结果的重要性。
前瞻性评估了100例脓毒症患者入院后第1天、第4天和第7天的氧化应激生物标志物（硫代巴比妥酸反应性物质[TBARS]）和抗氧化能力（谷胱甘肽过氧化物酶[GPx]和谷胱甘肽含量[硫醇]），同时收集生化和临床数据。
非存活组的TBARS水平在第1天和第4天显著高于存活组，且入院时与硫醇呈负相关。然而，硫醇与乳酸浓度呈正相关。入院时的TBARS和乳酸水平是死亡的独立预测因素。
我们得出结论，TBARS临界值为18.30 μM可用于预测死亡，TBARS浓度每增加1 μM，死亡率将增加0.94%。在生物标志物组中，TBARS检测可被视为脓毒症患者治疗的预后生物标志物。
