氧化应激对重症疟疾非洲儿童死亡和再入院风险的影响：一项前瞻性观察研究。

Impact of Oxidative Stress on Risk of Death and Readmission in African Children With Severe Malaria: A Prospective Observational Study.

机构信息

Department of Pediatrics, Division of Infectious Diseases, University of Louisville, Louisville, Kentucky, USA.

Department of Pediatrics, Division of Infectious Diseases, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.

出版信息

J Infect Dis. 2022 Sep 4;226(4):714-722. doi: 10.1093/infdis/jiac234.

DOI:10.1093/infdis/jiac234

PMID:35678643

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9890907/

Abstract

BACKGROUND

We hypothesized that oxidative stress in Ugandan children with severe malaria is associated with mortality.

METHODS

We evaluated biomarkers of oxidative stress in children with cerebral malaria (CM, n = 77) or severe malarial anemia (SMA, n = 79), who were enrolled in a randomized clinical trial of immediate vs delayed iron therapy, compared with community children (CC, n = 83). Associations between admission biomarkers and risk of death during hospitalization or risk of readmission within 6 months were analyzed.

RESULTS

Nine children with CM and none with SMA died during hospitalization. Children with CM or SMA had higher levels of heme oxygenase-1 (HO-1) (P < .001) and lower superoxide dismutase (SOD) activity than CC (P < .02). Children with CM had a higher risk of death with increasing HO-1 concentration (odds ratio [OR], 6.07 [95% confidence interval {CI}, 1.17-31.31]; P = .03) but a lower risk of death with increasing SOD activity (OR, 0.02 [95% CI, .001-.70]; P = .03). There were no associations between oxidative stress biomarkers on admission and risk of readmission within 6 months of enrollment.

CONCLUSIONS

Children with CM or SMA develop oxidative stress in response to severe malaria. Oxidative stress is associated with higher mortality in children with CM but not with SMA.

CLINICAL TRIALS REGISTRATION

NCT01093989.

摘要

背景

我们假设乌干达严重疟疾患儿的氧化应激与死亡率有关。

方法

我们评估了伴有脑疟疾（CM，n=77）或严重疟疾性贫血（SMA，n=79）的患儿的氧化应激生物标志物，这些患儿参与了即时与延迟铁治疗的随机临床试验，与社区儿童（CC，n=83）进行了比较。分析了入院时的生物标志物与住院期间死亡风险或 6 个月内再入院风险之间的关系。

结果

9 例 CM 患儿和 0 例 SMA 患儿在住院期间死亡。CM 或 SMA 患儿的血红素加氧酶-1（HO-1）水平较高（P<0.001），超氧化物歧化酶（SOD）活性较低（P<0.02）。CM 患儿的 HO-1 浓度越高，死亡风险越高（比值比[OR]，6.07[95%置信区间{CI}，1.17-31.31]；P=0.03），而 SOD 活性越高，死亡风险越低（OR，0.02[95%CI，0.001-0.70]；P=0.03）。入院时的氧化应激生物标志物与登记后 6 个月内的再入院风险之间没有关联。