氧化应激与创面愈合

Oxidative stress and wound healing

目的:创面愈合是一个复杂而有序的生物学过程,任何干扰创面愈合调控环节的内源性或外源性不良因素均可影响创面愈合的生物学过程。氧化应激对许多疾病的发展起着重要作用,现就氧化应激与创面愈合的关系做一阐述。资料来源:应用计算机检索Medline2001-01/2006-02关于氧化应激与创面愈合关系的相关文章,检索词为“oxidative stress,antioxidants,reactive oxygen species,wound repair,wound healing,diabetic wound,chronic wound,non-healing wound”,限定文章语言种类为English。并于清华同方,重庆维普中文数据库检索2001-01/2006-02关于氧化应激与创面愈合的关系的相关文章,检索词为“氧化应激、抗氧化剂,活性氧,创面修复、创面愈合、糖尿病创面、慢性创面、难愈性创面”,限定文章语言种类为中文。资料选择:对资料进行初筛,选择关于氧化应激与创面愈合关系的文献,对部分明显缺少随机对照的试验研究及重复研究进行筛除,并对剩余文献开始查找全文。资料提炼:共收集108篇关于氧化应激与创面愈合关系的文献,32篇纳入综述。排除76篇为明显缺少随机对照的试验研究或重复研究。资料综合:①氧化应激是机体促氧化剂和抗氧化剂稳态失衡,自由基的产生增多,和(或)机体或组织抗氧化能力下降的一种机体状态。过度的氧化应激可导致组织损害,对许多疾病的发展起着重要作用。②在发生氧化应激的过程中,自由基的产生相对增多。正常情况下,自由基反应对于机体防御机制是必要的,自由基的产生和清除保持平衡。③氧化应激与活性氧密切相关,活性氧既有其积极的一面,在一定程度上发挥其重要的生理学作用;当机体或组织不能抵御过度的活性氧,它也将导致组织或细胞损害。④皮肤创面在愈合的过程中产生过多的活性氧及其来源的降解产物。急慢性创面组织中促氧化能力增加,创伤后氧化应激的产生,慢性创面中抗氧化能力有所增加,间接反映氧化应激水平的升高,也反映出创面组织对氧化应激存在代偿和防御机制。⑤创面组织中氧化应激的产生可能与炎症反应密切相关。在创面愈合的炎症阶段,氧化应激作为促氧化剂与抗氧化剂内环境平衡失调而导致的组织损害。结论:在创面愈合的炎症时期以及慢性创面的治疗时应该考虑到氧化应激的存在,抗氧化治疗是一个治疗策略,适时给予抗氧化治疗将有助于创面愈合。

OBJECTIVE： Wound healing is a complex and sequential biological process, and it can be influenced by any intemal or external factors, which can interrupt each regulation of wound repair. Oxidative stress plays an important role in the development of all kinds of diseases. Currently, to demonstrate the relationship between oxidative stress and wound healing. DATA SOURCES： The relevant articles to the relation between oxidative stress and wound healing between January 2001 and February 2006 were retrieved from Medline using the key words of ＂oxidative stress, antioxidants, reactive oxygen species, wound repair, wound healing, diabetic wound, chronic wound, non-healing wound＂ in English. At the same time, related articles of the relation between oxidative stress and wound healing published from January 2001 to February 2006 were searched from China National Knowledge Infrastructure （CNKI） and Chongqing VIP Chinese Database with the same key words as above in Chinese. STUDY SELECTION： The articles about the relation between oxidative stress and wound healing were selected after they were primarily screened. Some articles obviously lacking of randomized controlled tdal （RCT） and repeated research were filtered. The rest full texts were searched. DATA EXTRACTION： Totally 108 articles about the relation between oxidative stress and wound healing were collected. Of them, 32 articles were accorded with the inclusive criteria, 76 articles were filtered due to obviously lacking of RCT or repeated research. DATA SYNTHESIS： ①Oxidative stress was a condition which was the imbalance of prooxidant and antioxidants, abnormally high levels of free radicals and/or the decline of antioxidant defense mechanisms. Excessive oxidative stress could lead to damage of tissue, which played an important role in the development of many kinds of diseases. ②Free radical relatively increased dudng oxidative stress. Normally free radical was necessary for defense of organism and there was a balance between its produce and scavenge. ③Oxidative stress was closely associated with reactive oxygen species. Reactive oxygen species could play an important role in physiology in some extent, also it led to damage of tissue or cells when organism could not defend excessive reactive oxygen species. ④Excesslve reactive oxygen species and its degradation product generated during the healing of cutaneous wound. Oxidation increased in acute and chronic wound. After wound oxidative stress generates, antioxidation increased in chronic wound, which indirectly reflected the increasing of oxidative stress and compensation and defense of tissue to oxidative stress. ⑤The generation of oxidative stress in wound maybe closely relate to inflammatory reaction. In the inflammatory stage of wound healing, oxidative stress induced the damage of tissue because of the imbalance of prooxidant and antioxidant, CONCLUSION： Oxidative stress should be considered in the inflammatory processes of wound healing and treatment of chronic wound. The treatment of antioxidation is a good strategy. If it is used in wound healing in time, it can be good to wound healing.