hrvatski

Dijagnostička i prognostička značajnost antioksidansa u politraumi

It has been undeniably established by past scientific research, including my master's thesis, that reduction in concentration of various antioxidants occurs in the state of traumatic shock. The aims of this study were the following: - to determine the changes in the following antioxidant concentrations in plasma or serum: vitamins E, C and A, selen, extracellular antioxidants (transferrin, haptoglobin, albumin, ceruloplasmin, bilirubin, urates, glucose), and antioxidant status in the group of patients in traumatic shock during at least 15-day hospital stay ; - to determine the changes in concentrations of the observed analytes in patients in traumatic shock that were administered vitamin E and C substitution therapy during their 7-day hospital stay ; - to examine effects of the therapy on concentrations of the above analytes ; - to compare relations between individual analytes ; - to examine the possible impact of the vitamin E and C substitution therapy on the therapy course ; - additional aim was to determine concentrations of lipid components of serum (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) in order to determine the relation between vitamin E concentration and total cholesterol, total lipids or certain lipoproteins, known as lipid peroxidation. The study included three groups of patients, aged 18-45 years ; one patient group (20) was administered intramuscular therapy (i.m.): 300 IU (150 IU vitamin E ampule x 29) and one vitamin C ampule i.v. (1000 mg vitamin C ampule) once a day during 7 days ; the second group (15) was administered per os therapy (p.o.): 1 ml oil solution of 400 IU/ml vitamin E and 1000 mg i.v. vitamin C once a day during 7 days ; and the third patient group (27) did not receive any therapy. Concentrations of these selected indicators were controlled on five occasions: on admission and on days 1, 3, 7, and 15 of the hospital stay. Vitamin E and C therapy caused changes in concentrations of a group of analytes. Comparison of concentration changes in patient groups during the period of observation undoubtedly demonstrated that vitamin E and C therapy positively affected the values of determined concentrations of both vitamins, and that their concentrations could reach the reference range in a significantly short period. Vitamin E and C therapy was relatively short so that we could not speak of clinically improved patient conditions but rather observe adequate regularities in analyte concentration changes which were the actual object of the study. Analysis of results obtained in this study and their comparison with previous investigations performed and published by other investigators led to the following conclusions: - During the first few hours, traumatic shock was the cause of a remarkable and significant decline in concentration of the following antioxidants: vitamins E, C and A, selen, extracellular antioxidants (transferrin, albumin, ceruloplasmin, bilirubin, urates), and in antioxidative ability. - Application of intramuscularly dosed vitamin E and intravenous vitamin C resulted in fast reaching of reference range values determining antioxidative capability of antioxidants, i.e. vitamins E and C, and of some other analytes, excepting selen. - Application of vitamin E and C did not affect selen concentration which remained significantly decreased during the patient follow-up ; this led to a conclusion that selen supplementation could cause status improvement in therapy and aid in fast establishment of the state of physiologic balance.

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