Plasma fatty acid changes and increased lipid peroxidation in patients with adult respiratory distress syndrome
Plasma fatty acid changes and increased lipid peroxidation in patients with adult respiratory distress syndrome
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DOI：
10.1097/00003246-199602000-00010
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发表时间：
1996-02-01
影响因子：
8.8
通讯作者：
Gutteridge, JMC
中科院分区：
文献类型：
--
作者：
Quinlan, GJ;Lamb, NJ;Gutteridge, JMC
目的：有强有力的证据表明，成人急性呼吸窘迫综合征(ARDS)患者处于严重的氧化应激状态，从而导致分子损伤。我们的目标是利用气相色谱-质谱仪(GC-MS)连续监测重症监护病房(ICU)患者血浆不饱和脂肪酸氧化丢失特征和亚油酸高特异性氧化产物4-羟基-2-壬烯的形成。设计：前瞻性、非干预性、描述性研究。地点：一所研究生教学医院的ICU。患者：18例确诊为ARDS且需要高F10(2)的危重患者接受机械通气治疗，与10名正常、健康对照和10名在体外循环手术前和术后有发生ARDS风险的患者进行比较。干预：无。测量和主要结果：本研究纳入的ARDS患者中60%存活。在ICU期间，所有患者的血浆脂肪酸浓度都发生了重大变化。血浆亚油酸浓度下降的百分比伴随着血浆油酸和棕榈油酸浓度的上升。ARDS患者的循环亚油酸浓度显著低于两个对照组(p=.0001)，死亡的ARDS患者的血浆油酸水平低于正常健康对照组和因接受体外循环手术而有ARDS风险的患者(p=.0056)。然而，棕榈油酸的变化在不同的研究小组中并没有达到显著的水平。急性呼吸窘迫综合征患者的血浆4-羟基-2-壬烯醛浓度(存活和死亡患者的血浆浓度分别为0.433+/-0.048和0.523+/-0.069 nmol/m L)高于正常对照组(0.205+/-0.03nm ol/m L，p=0.0001)和体外循环患者(0.279+/-0.027 nm o l/m L，p=0.034)。但增加了油酸和棕榈油酸的百分比浓度。随着血浆亚油酸浓度的降低，其特异性过氧化产物--4-羟基-2-壬烯醛的血浆浓度通常升高，提示严重的氧化应激导致脂质的分子损伤。
Objective: There is strong evidence that adult patients with acute respiratory distress syndrome (ARDS) are under severe oxidative stress, which leads to molecular damage.Using gas chromatography-mass spectrometry, our objective was to sequentially monitor changes, in intensive care unit (ICU) patients, characteristic of the oxidative loss of plasma unsaturated fatty acids and formation of the highly specific oxidation product of linoleic acid, 4-hydroxy-2-nonenal.Design: Prospective, nonintervention, descriptive study, Limited statistics were applied to facilitate interpretation of the data.Setting: ICU of a postgraduate teaching hospital.Patients: Eighteen critically ill patients with an established diagnosis of ARDS requiring high F10(2) administered by mechanical ventilation were compared with ten normal, healthy controls and ten patients pre- and postcardiopulmonary bypass surgery at risk for developing ARDS.Interventions: None.Measurements and Main Results: Sixty percent of the patients with ARDS included in this study survived. Major changes in the plasma concentrations of fatty acids occurred in all patients during their stay in the ICU. Percentage decreases in plasma linoleic acid concentrations were accompanied by increases in plasma oleic and palmitoleic acid concentrations. Circulating linoleic acid concentrations were significantly (p = .0001) lower in patients with ARDS than in the two control groups, The patients with ARDS who did not survive had lower (p = .0056) plasma oleic acid values than normal healthy controls and patients at risk for ARDS as a consequence of undergoing cardiopulmonary bypass surgery. Changes in palmitoleic acid, however, did not reach significance within the different groups studied. Patients with ARDS showed higher plasma concentrations of 4-hydroxy-2-nonenal (0.433 +/- 0.048 vs. 0.523 +/- 0.069 nmol/mL plasma for survivors and nonsurvivors, respectively) when compared with normal healthy controls (0.205 +/- 0.03 nmol/mL, p = .0001) and cardiopulmonary bypass patients at risk for developing ARDS (0.279 +/- 0.027 nmol/mL, p = .034 prebypass).Conclusions: During intensive care treatment, patients with ARDS decrease their percentage plasma concentrations of total plasma linoleic acid, but increase their percentage concentrations of oleic and palmitoleic acids. As plasma linoleic acid concentrations decreased, there was usually an increase in plasma 4-hydroxy-2-nonenal values, one of its specific peroxidation products, suggestive of severe oxidative stress leading to molecular damage to lipids.