Department of Neurosurgery, Aile Hospital, Istanbul, Turkey.
Department of Medical Biochemistry, Hamidiye School of Medicine, University of Health Sciences, Istanbul, Turkey.
J Neurol Surg A Cent Eur Neurosurg. 2023 Jul;84(4):321-328. doi: 10.1055/s-0041-1739207. Epub 2021 Dec 12.
One of the antioxidant mechanisms is the dynamic balance between thiol and disulfide, which, in subarachnoid hemorrhage and other chronic diseases, is disrupted in favor of the latter. The two most commonly used oxidative stress (OS) biochemical markers are the oxidative stress index (OSI) value, which indicates the total oxidant status (TOS) and total antioxidant status (TAS) balance, and the thiol-disulfide (TDS) value, which indicates the total thiol (TT) and native thiol (NT) balance. High OS levels require further investigations. We aimed to investigate the OS level in aneurysmal SAH (aSAH) patients.
In this clinical prospective study, blood samples were collected from 50 consecutively treated patients with aSAH and 50 volunteers. Serum TOS, TAS, TT, and NT levels were measured using Erel's method via a spectrophotometer. The Glasgow Coma Scale (GCS) scores, Fisher grades, length of hospital stay (LOS), and the Glasgow Outcome Scale (GOS) scores were recorded. Consequently, the OSI and TDS values were calculated in all participants.
A statistically significant difference was observed in the TAS, TOS, OSI, and TDS values between the aSAH patients and the controls. The TT and NT values were significantly lower in aSAH patients than in the controls. A correlation was identified between the OSI values and the GCS scores. Although a correlation was observed between the TDS values and the LOS, no correlation was found between the OSI and the TDS values.
The OSI and TDS, which are OS indicators, might serve as the additional objective nominal data to evaluate the treatment efficacy and follow-up for SAH patients. Moreover, decreasing the OSI values and increasing the TT values can be used as improvement indicators in the treated aSAH patients. If we can reduce the OS at the early stage of SAH, it could improve the prognosis by reducing both the morbidity and mortality rates. Further randomized investigations are required to prove the findings in this prospective study.
抗氧化机制之一是巯基和二硫键之间的动态平衡，在蛛网膜下腔出血和其他慢性疾病中，这种平衡有利于后者。两个最常用的氧化应激（OS）生化标志物是氧化应激指数（OSI）值，它表示总氧化剂状态（TOS）和总抗氧化状态（TAS）的平衡，以及巯基-二硫键（TDS）值，它表示总巯基（TT）和天然巯基（NT）的平衡。高 OS 水平需要进一步调查。我们旨在研究动脉瘤性蛛网膜下腔出血（aSAH）患者的 OS 水平。
在这项临床前瞻性研究中，从 50 名连续治疗的 aSAH 患者和 50 名志愿者中采集血样。使用分光光度计通过 Erel 法测量血清 TOS、TAS、TT 和 NT 水平。记录格拉斯哥昏迷量表（GCS）评分、Fisher 分级、住院时间（LOS）和格拉斯哥结局量表（GOS）评分。随后，计算所有参与者的 OSI 和 TDS 值。
aSAH 患者与对照组之间 TAS、TOS、OSI 和 TDS 值存在统计学显著差异。aSAH 患者 TT 和 NT 值明显低于对照组。OSI 值与 GCS 评分之间存在相关性。尽管 TDS 值与 LOS 之间存在相关性，但 OSI 和 TDS 值之间不存在相关性。
作为 OS 指标的 OSI 和 TDS 可能作为评估 SAH 患者治疗效果和随访的额外客观命名数据。此外，降低 OSI 值和增加 TT 值可作为治疗后 aSAH 患者的改善指标。如果我们能在 SAH 的早期阶段降低 OS，通过降低发病率和死亡率，就能改善预后。需要进一步的随机研究来证明本前瞻性研究中的发现。
