Dabrowski A, Jedynak M, Gabryelewicz A
Gastroenterology Department, Medical School, Bialystok, Poland.
Pancreas. 1998 Aug;17(2):163-8.
The role of oxidative stress as an important pathogenetic factor in experimental AP is commonly accepted, but its role in human AP has still not been evaluated satisfactorily. In the present study we compared the parameters of oxidative stress to the level of PLA2 and PMN-E in patients with AP. The study was performed in 77 patients with mild (n = 31), moderate (n = 20), and severe (n = 26) AP (alcoholic and biliary) as assessed according to Ranson's and Balthazar's criteria. Serum and urine malondialdehyde (MDA) concentrations, as an index of oxidant-mediated lipid peroxidation, and sulfhydryl (SH) groups, a major nonenzymatic antioxidant, were measured along with serum PLA2 and plasma PMN-E at admission (day 0) and on days 2, 5, and 10 of the disease. The Serum MDA level in severe AP was elevated by 267% on day 0 and 230% after 10 days, in comparison to the control, by 104 and 105% in comparison to mild AP, and by 50 and 76% in comparison to moderate AP, respectively. This was accompanied by a decrease in serum SH groups by 23% on day 0 and 36% after 10 days, in comparison to the control, by 31 and 32% in comparison to mild AP, and by 20 and 11% (ns) in comparison to moderate AP, respectively. In all severity forms of AP, oxidative stress was proportionally accompanied by increased levels of PLA2 and plasma PMN-E. In conclusion, oxidative stress is an early phenomenon in patients with AP, and at the time of admission it is detectable in the serum and urine. The intensity of oxidative stress correlates with the severity of AP. Because of the significant correlation between MDA and PLA2 or PMN-E, we suppose that the parameters of oxidative stress may be useful as another early prognostic factor in human AP.
氧化应激作为实验性急性胰腺炎（AP）的一个重要发病因素，这一观点已被广泛接受，但它在人类AP中的作用仍未得到令人满意的评估。在本研究中，我们比较了AP患者氧化应激参数与磷脂酶A2（PLA2）水平及中性粒细胞弹性蛋白酶（PMN-E）水平。本研究纳入了77例根据兰森标准和巴尔萨泽标准评估为轻度（n = 31）、中度（n = 20）和重度（n = 26）的AP（酒精性和胆源性）患者。在入院时（第0天）以及疾病的第2、5和10天，检测血清和尿液中丙二醛（MDA）浓度（作为氧化介导的脂质过氧化指标）以及巯基（SH）基团（一种主要的非酶抗氧化剂），同时检测血清PLA2和血浆PMN-E。与对照组相比，重度AP患者血清MDA水平在第0天升高了267%，10天后升高了230%；与轻度AP相比，分别升高了104%和105%；与中度AP相比，分别升高了50%和76%。与此同时，与对照组相比，血清SH基团在第0天减少了23%，10天后减少了36%；与轻度AP相比，分别减少了31%和32%；与中度AP相比，分别减少了20%和11%（无统计学意义）。在所有严重程度的AP中，氧化应激均相应地伴随着PLA2水平和血浆PMN-E水平的升高。总之，氧化应激是AP患者的一种早期现象，在入院时可在血清和尿液中检测到。氧化应激的强度与AP的严重程度相关。由于MDA与PLA2或PMN-E之间存在显著相关性，我们推测氧化应激参数可能作为人类AP的另一个早期预后因素。
