The Role of Serial Oxidative Stress Levels in Acute Traumatic Brain Injury and as Predictors of Outcome

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• 作者：Hung-Chen Wang¹ ; Yu-Jun Lin¹ ; ² ; Fu-Yuan Shih¹ ; Hsueh-Wen Chang² ; ³ ; Yu-Jih Su³ ; Ben-Chung Cheng² ; ³ ; Chih-Min Su⁴ ; Nai-Wen Tsai⁵ ; Ya-Ting Chang² ; ⁵ ; Aij-Lie Kwan⁶ ; Cheng-Hsien Lu² ; ⁵ ; ⁷ ; ^{chlu99@ms44.url.com.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Glutathione ; Outcome ; Oxidative stress ; Traumatic brain injury
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：87
• 期：Complete
• 页码：463-470
• 全文大小：4868 K

文摘

Oxidative stress is thought to participate in the pathobiology of secondary brain injury after acute traumatic brain injury (TBI). This study posits that oxidative stress levels in acute TBI are predictive of outcome.

Methods

Two hundred and twenty-nine blood samples from 88 patients admitted within 24 hours after TBI were obtained on admission and on days 4 and 7. Serial plasma oxidative level and antioxidant were examined in 88 patients with acute TBI and 27 control individuals.

Results

Compared with controls, patients with TBI had significantly increased serum glutathione (GSH) levels on presentation and significantly decreased erythrocyte superoxide dismutase levels. Outcome was assessed on discharge using the Glasgow Outcome Scale. Serum GSH and erythrocyte superoxide dismutase levels were significantly higher in the good outcome group than in the poor outcome group on day 1 (P = 0.008 and P = 0.026, respectively). In the logistic regression analysis, only motor deficits and GSH levels on presentation were independently associated with outcome. A GSH cutoff value of 1.106 μmol/L on presentation was associated with good outcome in patients with acute TBI.

Conclusions

Quantifying biomarkers of oxidative stress and antioxidant status of serum correlate with trauma severity and may be used to predict outcomes after TBI. Higher serum GSH levels on admission are associated with better outcome.