糖尿病对烧伤创面氧化应激状态的影响

目的：研究糖尿病（DM）对烧伤患者机体血清和烧伤创面氧化应激状态的影响，探讨DM烧伤创面愈合延迟或者不愈合发生的可能机制。方法：选择2型DM合并烧伤患者26例（DM-B组），单纯烧伤患者22例（Burn组），并选择同期匹配单纯DM患者20例（DM组）及健康人群21例（对照组）。收集受检者的空腹血清、创面组织标本测定超氧化物歧化酶（SOD）及丙二醛（MDA）水平。结果：①DM-B组、Burn组和DM组患者的血清标本中SOD活性、MDA水平与对照组比较差异均有统计学意义（P＜0.05）。与Burn组比较，DM-B组血清SOD活性进一步下降，MDA水平进一步升高（P＜0.05）。②DM-B组患者创面组织中MDA含量在各时相点与Burn组相比均明显升高，SOD活性均明显降低（P＜0.05），且这种差异至烫伤后21 d仍显著。结论：DM烧伤创面氧化应激明显增强，可能是DM烧伤创面愈合延迟或者不愈合发生的机制之一。

Effects of diabetes on oxidative stress in burn wounds

Objective: To observe the metabolite level of oxidative stress in burned patients with or without type 2 diabetes mellitus, and to explore the relationship between oxidative stress and diabetic burned wounds. Methods: The patients were divided into 3 groups, including burned patients without DM (Burn group), burned patients with DM (DM-B group) and DM without burns. And another 21 healthy subjects were enrolled as control group. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in plasma and wounds were detected. Results: The plasma levels of SOD in the DM-B group, Burn group and DM group were lower than that of the control group (P<0.05). The plasma concentrations of MDA were statistically significantly higher in the groups of DM-B, Burn and DM in comparison with the control group. The levels of SOD in the burn wounds were lower in DM-B group compared to Burn group on the 1st day following injury (P<0.05), which maintained until the 21st day. In DM-B group a statistically significant increase of the MDA was observed from the 1st day until the 21st day. Conclusion: These data show evidence of a marked,long-lasting oxidative stress in burned patients with DM compared to the burned patients without DM. For this reason, burned patients with DM are recommended to receive exogenous antioxidants.