Patients with polytrauma were divided into two groups according to injury severity score (ISS). Group I (10 subjects) consisted of patients who scored less than 25; group II included patients who scored 25 to 49. The study demonstrated a significant increase in NO(x) and MDA levels, as well as ACE activity in groups I and II. NO(x) level displayed a positive correlation with ISS in both groups. The same was demonstrated for ACE activity. In the control group (21 donors) NO(x) level positively correlated with serum ACE activity. However, while NO(x) level positively correlated with ACE activity in group I, this correlation was not observed in group II, suggesting an impairment of conjugated vascular tone regulation caused by imbalance between NO(x) and ACE in patients with more severe injuries. The multifold increase in the level of MDA, the main oxidative stress parameter, in group I and II, indicates the necessity to include antioxidants in complex therapy of patients with polytrauma.
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