The Study Of Oxidative Stress Status And Related Biomarkers In Sepsis

Objective:We sought to research the oxidative stress statue and to determine whether the MDA?SOD and ratio of serum SOD to MDA(SOD/MDA)could be correlated to disease severity in sepsis;To search the biomarkers used to early dignosis sepsis and to predict the prognosis in sepsis.Methods:1.The study of oxidative stress status in sepsis:this single-center prospective observational study was performed from November 1st,2016 to September 31th,2017,in the ICU of the First Affiliated Hospital,College of Medicine,Zhejiang University.A total of 120 septic patients and 60 healthy volunteer control subjects were included in the study.Blood samples were collected within 24 hours after admission to the ICU(day 1)and within 24 hours before they were discharged from ICU or deceased in ICU(day last),to measure the levels of serum MDA and SOD then calculated the SOD/MDA ratio.We also record the age,gender,underlying diseases,infection site,SOFA score about patients,and divided all septic patients into three groups:SOFA<6 group,SOFA 6-10 group,SOFA>10 group in order to subgroup analysis.2.The study of sepsis-related biomarkers in septic patients:this single-center prospective observational study was also performed from November 1st,2016 to September 31th,2017,in the ICU of the First Affiliated Hospital,College of Medicine,Zhejiang University.A total of 125 septic patients and 79 non-septic patients were included in the study,and blood samples were collected within 24 hours after admission to the ICU(day 1).All the patients measured the levels of serum white blood cell,CRP,PCT,DD,IL-6,MDA,and SOD,we analyzed their diagnostic value in sepsis.According to the survival statue when they got out of the ICU,we divided all septic patients into two groups:survival group and non-survival group,to evaluate the prognostic value of these biomarkers.Results:1.The study of oxidative stress status in sepsis:both in the survival and the non-survival groups,serum MDA and SOD levels on day 1 and day last were higher than in the healthy control group.Serum MDA level was lower on day last than on day 1 in the survival group,while the opposite was true for the non-survival group.Non-survivors had a lower SOD/MDA ratio than survivors on day last.Additionally,the serum SOD/MDA ratio for the non-survival group decreased from day 1 to day last When stratified based on sequential organ failure assessment(SOFA)scores,serum MDA and SOD levels in the SOFA>10 group were significantly higher than in the SOFA<6 and SOFA 6-10 groups,whereas the SOD/MDA ratio was lower.2.The study of sepsis-related biomarkers in septic patients:serum MDA,DD,PCT,MDA,IL-6 levels in sepsis were higher than the control group.ROC curve paired comparison showed that serum CRP,DD,IL-6,PCT had higher identification value.Serun PCT level and SOFA score were higher in the non-survival group than in the survival group,ROC curve also showed that serum PCT and SOFA score had higher prediction vaule for estimating prognosis in sepsis.Conclusions:1.In the presence of severe oxidative stress,the human body possesses compensatory but limited antioxidant capacity.SOD/MDA ratio could better reflect the balance between oxidation and antioxidant capacity.2.Serum CRP,PCT,MDA,IL-6,and DD involve in the occurrence and development of sepsis and could be used to identify early sepsis.Serum PCT and SOFA score had higher predicition value for estimating prognosis in sepsis.