Segmen Fatih, Aydemir Semih, Küçük Onur, Doğu Cihangir, Dokuyucu Recep
Department of Intensive Care Unit, Ankara City Hospital, Ankara 06800, Türkiye.
Department of Anesthesiology and Reanimation, Yenimahalle Training and Research Hospital, University of Yıldırım Beyazit, Ankara 06800, Türkiye.
J Clin Med. 2024 Nov 20;13(22):6979. doi: 10.3390/jcm13226979.
The aim of this study is to assess the oxidative stress status in patients requiring intensive care unit (ICU) admission before initiating ICU treatment, by measuring the total oxidant level (TOS) and total antioxidant level (TAS) and oxidative stress index (OSI) levels. Additionally, we aim to explore the correlation between these oxidative stress markers and biochemical and hematological parameters. A total of 153 patients treated in intensive care units were included in the study. Patients who met the patient admission criteria of the ethics committee of the intensive care medicine association were included in the study. Blood samples were taken at the first moment the patients were admitted to the intensive care unit (before starting treatment). In total, 60 healthy volunteers who were compatible with the patient group in terms of age and gender were included in the study as a control group. Patients who had previously received antioxidant treatment and cancer patients were excluded from the study. The TOS was significantly higher in the patient group (13.4 ± 7.5) compared to controls (1.8 ± 4.4) ( = 0.021). TOS > 12.00 means a "very high oxidant level". OSI was significantly higher in the patient group (689.8 ± 693.9) compared to the control group (521.7 ± 546.6) ( = 0.035). Ferritin levels were significantly higher in the patient group (546.5 ± 440.8 ng/mL) compared to controls (45.5 ± 46.5 ng/mL) ( < 0.001). Patients had significantly higher levels of C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBCs), immature granulocytes (IGs), zinc, and copper compared to the control group, indicating elevated inflammation and oxidative stress. CRP levels were 76.6 ± 85.9 mg/L in patients versus 5.6 ± 15.1 mg/L in controls ( < 0.001). PCT levels were 15.8 ± 8.6 ng/L in patients versus 2.3 ± 7.2 ng/L in controls ( = 0.012). Zinc and copper were also significantly elevated ( = 0.012 and = 0.002, respectively). Our study provides valuable insights into the relationship between oxidative stress, inflammation, and trace elements, contributing to the growing understanding of oxidative stress as a prognostic tool in critical care. This could help to tailor therapeutic strategies aimed at reducing oxidative damage in ICU patients, enhancing patient outcomes.
本研究的目的是通过测量总氧化剂水平（TOS）、总抗氧化剂水平（TAS）和氧化应激指数（OSI），评估在开始重症监护病房（ICU）治疗前需要入住ICU的患者的氧化应激状态。此外，我们旨在探讨这些氧化应激标志物与生化和血液学参数之间的相关性。本研究共纳入了153例在重症监护病房接受治疗的患者。符合重症医学协会伦理委员会患者入院标准的患者被纳入研究。在患者入住重症监护病房的第一时间（开始治疗前）采集血样。总共60名在年龄和性别方面与患者组匹配的健康志愿者作为对照组纳入研究。先前接受过抗氧化治疗的患者和癌症患者被排除在研究之外。与对照组（1.8±4.4）相比，患者组的TOS显著更高（13.4±7.5）（P = 0.021）。TOS>12.00意味着“非常高的氧化剂水平”。与对照组（521.7±546.6）相比，患者组的OSI显著更高（689.8±693.9）（P = 0.035）。与对照组（45.5±46.5 ng/mL）相比，患者组的铁蛋白水平显著更高（546.5±440.8 ng/mL）（P<0.001）。与对照组相比，患者的C反应蛋白（CRP）、降钙素原（PCT）、白细胞（WBC）、未成熟粒细胞（IG）、锌和铜水平显著更高，表明炎症和氧化应激升高。患者的CRP水平为76.6±85.9 mg/L，而对照组为5.6±15.1 mg/L（P<0.001）。患者的PCT水平为15.8±8.6 ng/L，而对照组为2.3±7.2 ng/L（P = 0.012）。锌和铜也显著升高（分别为P = 0.012和P = 0.002）。我们的研究为氧化应激、炎症和微量元素之间的关系提供了有价值的见解，有助于加深对氧化应激作为重症监护中预后工具的理解。这有助于制定旨在减少ICU患者氧化损伤的治疗策略，提高患者的治疗效果。
