Oxidative stress is increased in critically ill patients according to antioxidant vitamins intake, independent of severity: a cohort study.
Oxidative stress is increased in critically ill patients according to antioxidant vitamins intake, independent of severity: a cohort study.
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根据抗氧化剂维生素的摄入，重症患者的氧化应激增加，与严重程度无关：一项队列研究。
DOI：
10.1186/cc5068
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发表时间：
2006
期刊：
影响因子：
15.1
通讯作者：
Planells, Elena Maria
中科院分区：
文献类型：
--
作者：
Abiles, Jimena;de la Cruz, Antonio Perez;Castano, Jose;Rodriguez-Elvira, Manuel;Aguayo, Eduardo;Moreno-Torres, Rosario;Llopis, Juan;Aranda, Pilar;Argueelles, Sandro;Ayala, Antonio;de la Quintana, Alberto Machado;Planells, Elena Maria
危重患者遭受活性氧（ROS）和活性氮（RNS）引起的氧化应激。尽管 ROS/RNS 在正常情况下会不断产生，但危重疾病会大幅增加其产生。这些患者的血浆和细胞内抗氧化剂和游离电子清除剂或辅助因子的水平降低，并且参与ROS解毒的酶系统的活性降低。促氧化剂/抗氧化剂平衡在危重疾病期间具有功能相关性，因为它涉及多器官衰竭的发病机制。本研究的目的是评估危重患者的氧化应激与抗氧化维生素摄入量和疾病严重程度之间的关系。使用分光光度法测量两个时间点血浆中的总抗氧化能力以及脂质过氧化物、羰基、总蛋白、胆红素和尿酸的水平：重症监护病房（ICU）入院时和第七天。保存每日饮食记录，并评估抗氧化维生素（A、C和E）的推荐膳食摄入量（RDA）的遵守情况。从入院到入住 ICU 第七天，脂质过氧化物和羰基的显着增加与抗氧化能力下降和序贯性器官衰竭评估评分恶化有关。接受低于 RDA 66% 的抗氧化维生素的患者的氧化应激参数恶化程度明显高于接受高于 RDA 66% 的抗氧化维生素的患者。无论疾病严重程度如何变化（序贯器官衰竭评估评分），抗氧化维生素摄入量从 RDA 的 66% 到 100% 都能将氧化应激恶化的风险降低 94%（ods 比 0.06，95% 置信区间 0.010 到 0.39）。入住 ICU 的患者病情危重与氧化应激恶化有关。抗氧化维生素的摄入量低于每日推荐摄入量的66%以及具有抗氧化能力的内源性物质水平的改变与危重患者的氧化还原失衡有关。因此，应仔细监测抗氧化维生素的摄入量，使其尽可能接近 RDA。
Critically ill patients suffer from oxidative stress caused by reactive oxygen species (ROS) and reactive nitrogen species (RNS). Although ROS/RNS are constantly produced under normal circumstances, critical illness can drastically increase their production. These patients have reduced plasma and intracellular levels of antioxidants and free electron scavengers or cofactors, and decreased activity of the enzymatic system involved in ROS detoxification. The pro-oxidant/antioxidant balance is of functional relevance during critical illness because it is involved in the pathogenesis of multiple organ failure. In this study the objective was to evaluate the relation between oxidative stress in critically ill patients and antioxidant vitamin intake and severity of illness. Spectrophotometry was used to measure in plasma the total antioxidant capacity and levels of lipid peroxide, carbonyl group, total protein, bilirubin and uric acid at two time points: at intensive care unit (ICU) admission and on day seven. Daily diet records were kept and compliance with recommended dietary allowance (RDA) of antioxidant vitamins (A, C and E) was assessed. Between admission and day seven in the ICU, significant increases in lipid peroxide and carbonyl group were associated with decreased antioxidant capacity and greater deterioration in Sequential Organ Failure Assessment score. There was significantly greater worsening in oxidative stress parameters in patients who received antioxidant vitamins at below 66% of RDA than in those who received antioxidant vitamins at above 66% of RDA. An antioxidant vitamin intake from 66% to 100% of RDA reduced the risk for worsening oxidative stress by 94% (ods ratio 0.06, 95% confidence interval 0.010 to 0.39), regardless of change in severity of illness (Sequential Organ Failure Assessment score). The critical condition of patients admitted to the ICU is associated with worsening oxidative stress. Intake of antioxidant vitamins below 66% of RDA and alteration in endogenous levels of substances with antioxidant capacity are related to redox imbalance in critical ill patients. Therefore, intake of antioxidant vitamins should be carefully monitored so that it is as close as possible to RDA.
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