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An observational study on the relationship between plasma vitamin C, blood glucose, oxidative stress, endothelial dysfunction and outcome in patients with septic shock

机译：脓液休克患者血浆维生素C，血糖，氧化应激，内皮功能障碍和结果关系的观察研究

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Background. Septic shock is associated with endothelial dysfunction and oxidative stress, against which vitamin C plays a protective role, possiblyinfluencing clinical outcome. Hyperglycaemia may lower vitamin C.Objective. To study plasma vitamin C, oxidative stress, hyperglycaemia, endothelial dysfunction and outcome in septic shock.Methods. In a prospective, observational study of 25 adult septic shock patients, serial blood samples were analysed for vitamin C, thiobarbituricacid-reactive substances (TBARS) (a biomarker of oxidative stress), and soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin(markers of endothelial dysfunction). Blood glucose, Sequential Organ Failure Assessment (SOFA) scores and fluid requirements were monitored.Results. Plasma vitamin C was low, while plasma TBARS were high throughout the 7-day study period. Endothelial dysfunction markers (sVCAM-1and E-selectin) were high at the baseline. VCAM-1 decreased significantly on day 1 and normalised on day 7. E-selectin was unchanged on day 1compared with baseline, but increased significantly on day 7. Oxidative stress and endothelial dysfunction were associated with increased SOFAscore. Increased oxidative stress was associated with increased requirements for intravenous fluids and prolonged duration of vasoconstrictorsupport. Nine patients died in hospital. At baseline, levels of TBARS were significantly higher in non-survivors than in the survivors of septic shock.Conclusion. In septic shock, clinically relevant oxidative stress was associated with endothelial dysfunction, low vitamin C and high glucoseto-vitamin-C ratios. Markers of oxidative stress and endothelial damage were increased and correlated with resuscitation fluid requirements,vasoconstrictor use, organ failure and mortality.
机译：背景。脓毒性休克是与内皮功能障碍和氧化应激，针对其维生素C起着保护作用，possiblyinfluencing临床结果相关联。高血糖可降低维生素C.Objective。为了研究血浆维生素C，氧化应激，高血糖症，血管内皮功能障碍和结果脓毒症shock.Methods。在25成人脓毒性休克的患者前瞻性，观察研究，串行血液分析样品的维生素C，thiobarbituricacid反应物质（TBARS）（氧化应激的生物标志物），和可溶性血管细胞黏附分子-1（血清sVCAM-1）和E-selectin（内皮功能障碍的标记）。血糖，序贯器官衰竭评估（SOFA）评分和流体的要求是monitored.Results。血浆维生素C为低，而血浆TBARS在整个7天的研究期间高。内皮功能障碍标志物（血清sVCAM-1和E-选择素）是高在基线。 VCAM-1显著降低在第1天，并归一化第7天E-选择是在白天与基线1compared不变，但第7天氧化应激和血管内皮功能障碍显著增加用增加SOFAscore相关联。增加的氧化应激与用于静脉注射液和vasoconstrictorsupport的延长持续时间增加的需求相关联。名患者在医院死亡。在基线，TBARS的水​​平在未存活者比化粪池shock.Conclusion的幸存者显著较高。在脓毒性休克，临床相关的氧化应激与内皮功能障碍，低维生素C和高glucoseto维生素-C比相关联。氧化应激和血管内皮损伤的标记物增加，并与复苏液的要求，血管收缩剂使用，器官衰竭和死亡相关。

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