Tsai K, Wang S S, Chen T S, Kong C W, Chang F Y, Lee S D, Lu F J
Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Gut. 1998 Jun;42(6):850-5. doi: 10.1136/gut.42.6.850.
Reactive oxygen species and related oxidative damage have been implicated in the initiation of acute pancreatitis. Changes in these parameters during disease progression merit further investigation.
To evaluate changes and the clinical relevance of superoxide radicals, endogenous antioxidants, and lipid peroxidation during the course of acute pancreatitis.
Superoxide radicals (measured as lucigenin amplified chemiluminescence), ascorbic acid, dehydroascorbic acid, alpha tocopherol, and lipid peroxidation (measured as thiobarbiturate reactive substances) were analysed in blood samples from 56 healthy subjects, 30 patients with mild acute pancreatitis, and 23 patients with severe acute pancreatitis. The association with grades of disease severity was analysed. Measurements were repeated one and two weeks after onset of pancreatitis.
In the blood from patients with acute pancreatitis, there were increased levels of the superoxide radical as well as lipid peroxides. There was notable depletion of ascorbic acid and an increased fraction of dehydroascorbic acid. Changes in alpha tocopherol were not great except in one case with poor prognosis. Differences between severe and mild acute pancreatitis were significant (p < 0.01). Variable but significant correlations with disease severity scores were found for most of these markers. The normalisation of these indexes postdated clinical recovery one or two weeks after onset of disease.
Heightened oxidative stress appears early in the course of acute pancreatitis and lasts longer than the clinical manifestations. The dependence of disease severity on the imbalance between oxidants and natural defences suggests that oxidative stress may have a pivotal role in the progression of pancreatitis and may provide a target for treatment.
活性氧及其相关的氧化损伤与急性胰腺炎的发病有关。疾病进展过程中这些参数的变化值得进一步研究。
评估急性胰腺炎病程中超氧自由基、内源性抗氧化剂和脂质过氧化的变化及其临床相关性。
分析了56名健康受试者、30名轻度急性胰腺炎患者和23名重度急性胰腺炎患者血样中的超氧自由基（以光泽精增强化学发光法测定）、抗坏血酸、脱氢抗坏血酸、α-生育酚和脂质过氧化（以硫代巴比妥酸反应性物质测定）。分析了其与疾病严重程度分级的相关性。在胰腺炎发病后1周和2周重复测量。
急性胰腺炎患者血液中超氧自由基和脂质过氧化物水平升高。抗坏血酸显著消耗，脱氢抗坏血酸比例增加。除1例预后较差的病例外，α-生育酚变化不大。重度和轻度急性胰腺炎之间的差异具有显著性（p<0.01）。这些标志物中的大多数与疾病严重程度评分存在不同程度但显著的相关性。这些指标的恢复正常比疾病发作后临床恢复晚1至2周。
氧化应激在急性胰腺炎病程早期就出现，且持续时间比临床表现更长。疾病严重程度对氧化剂与天然防御失衡的依赖性表明，氧化应激可能在胰腺炎进展中起关键作用，并可能提供治疗靶点。
