Winnefeld K, Schirrmeister W, Thiele R, Sperschneider H, Klinger G
Institut für Klinische Chemie und Laboratoriumsdiagnostik, Jena.
Med Klin (Munich). 1995 Jan 15;90 Suppl 1:7-9.
All healthy mammalian organisms are characterized by an equilibrium between the occurrence of highly reactive oxygen species and their destruction by anti-oxidants. Numerous diseases go hand in hand with a disturbance of the homoeostatis. In order to avoid or minimize the destructive effect of the oxidant stress on biological structures, therapies utilizing drugs with anti-oxidant effects are increasingly being applied. Preconditions for these therapies are a characterisation and a follow-up of the anti-oxidant status in the diseased organism. In the course of the present study selenium, glutathione peroxidase and malondialdehyde were determined in patients with various clinical pictures (terminal renal insufficiency, septic shock, high-risk gravidieties, arterioscleroisis, pulmonary carcinoma, acute myocardial infarction, test patients taking the contraceptive pill). Patients with terminal renal insufficiency and those suffering from septic shock syndromes clearly show a selenium decrease in serum and whole blood as well as a drop in the GSH-Px-activity, and increased malondialdehyde concentrations in the serum. Both are a reflection of an increased lipid peroxidation. First results of a selenium therapy are available for patients with therminal renal insufficiency and post-traumatically induced renal failure. The interpretation of the findings in the categories "high-risk gravidity" and "women on the contraceptive pill", which show a normal GSH-Px-activity and significantly increased malondialdehyde concentrations, seems problematic. The organism counteracts an increased lipid peroxidation with a normal plasma-GSH-Px-activity, clearly a sign of a still normal anti-oxidant potential.
所有健康的哺乳动物机体都具有高活性氧的产生与抗氧化剂对其破坏作用之间的平衡这一特征。许多疾病都与这种内稳态的紊乱相伴而生。为了避免或最小化氧化应激对生物结构的破坏作用，越来越多地应用具有抗氧化作用药物的治疗方法。这些治疗方法的前提是对患病机体的抗氧化状态进行表征和跟踪。在本研究过程中，对患有各种临床病症（终末期肾功能不全、脓毒症休克、高危妊娠、动脉硬化、肺癌、急性心肌梗死、服用避孕药的受试患者）的患者测定了硒、谷胱甘肽过氧化物酶和丙二醛。终末期肾功能不全患者和患有脓毒症休克综合征的患者血清和全血中的硒明显降低，谷胱甘肽过氧化物酶活性下降，血清中丙二醛浓度升高。这两者都是脂质过氧化增加的反映。对于终末期肾功能不全和创伤后诱发肾衰竭的患者，已有硒治疗的初步结果。对“高危妊娠”和“服用避孕药的女性”这两类患者的研究结果解读存在问题，这些患者谷胱甘肽过氧化物酶活性正常，但丙二醛浓度显著升高。机体以正常的血浆谷胱甘肽过氧化物酶活性来对抗脂质过氧化增加，这显然是抗氧化潜能仍正常的一个迹象。
