肺结核患者氧化／抗氧化失衡的初步研究

Study on the Imbalance between Oxidants and Antioxidants in Patients with Pulmonary Tuberculosis

目的 探讨肺结核患者氧化航氧化失衡的特点及相关影响因素，观察肺结核患者抗氧化治疗的疗效和意义。方法用分光光度法对20例正常对照者和120例肺结核患者血清的超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GPX）、丙二醛（MDA）进行检测，同时对20例肺结核患者经N-乙酰半胱氨酸（NAC）治疗前后的SOD、GPX、MDA进行测定和观察。结果①与正常对照组相比，肺结核患者血清SOD、GPX活性降低，MDA含量增加（P〈0．01）。②伴有空洞、纤维化和／或毁损肺的肺结核患者以及血沉增快的患者SOD、GPX进一步降低（P〈0．01），但MDA无显著性变化。③合并肺气肿、肺心病患者的SOD、GPX、MDA与无合并症的患者相接近（P〉0．05）。④在应用N-乙酰半胱氨酸后，患者的SOD、GPX增高（P〈0．05），但MDA无显著性变化。结论肺结核患者存在着氧化／抗氧化失衡；肺结核病变的影像学特点及结核的活动性与肺结核患者氧化／抗氧化失衡的进一步加重有关；联合应用NAC对肺结核患者进行抗氧化治疗可提高肺结核患者的抗氧化能力。

Objective To investigate the feature and influential factors of imbalance between oxidants and antioxidants of pulmonary tuberculosis（TB）, and to observe the therapeutic effect of antioxidant for patients with pulmonary TB. Methods：The super-oxide dismutase （SOD）, glutathione peroxidase （GPX） and malonaldehyde（MDA） were detected by spectrophotometry in the sera of 20 healthy controls and 120 patients with pulmonary TB. And the changes of SOD,GPX,MDA in 20 patients with pulmonary TB were observed before and after treated with N-acetylcysteine. Results ①Compared with the healthy controls, the level of SOD,GPX decreased and MDA increased in pulmonary TB group（P〈0.01）. ② The SOD,GPX were further decreased in the pulmonary TB patients with eavitates or fibrosis and in patients of faster erythroeyte sedimentation rate（P〈0.01）,but there were no remarkable difference of MDA between the two groups. ③The levels of SOD,GPX,MDA of patients complicated with emphysema or eor pulmonale were close to those patients without complications （P〉0.05）.④The levels of SOD, GPX increased in the patients after treated with NAC （P〈0.05）,but in MDA there was no significant change. Conclusions The imbalance between oxidants and antioxidants is present in patients with pulmonary TB. The further aggravation of imbalance in patients is associated with TB lesion＇s imaging feature and TB＇s reactiveness. The use of NAC can enhance the patients＇ antioxidative ability.