Taha Dhia A, Thanoon Imad A-J
Al-Salaam Hospital, Mosul City, Iraq.
Sultan Qaboos Univ Med J. 2010 Dec;10(3):361-9. Epub 2010 Nov 14.
The objective of this study was to evaluate the influence of acute pulmonary tuberculosis and the effect of drug therapy on markers of oxidative stress (malondialdehyde [MDA] and total antioxidant status [TAS]), C-reactive protein (CRP) and iron body status indices.
Forty patients with active pulmonary tuberculosis from the Advisory Clinic for Chest and Respiratory Diseases in Mosul City, Iraq, were included in this study, with fifty healthy age and sex matched subjects as controls. Assessment of serum concentrations of MDA, TAS, CRP, serum iron, total iron binding capacity, transferring saturation percent and ferritin were done for both patients and controls. After two months of therapy with a daily dose of isoniazid 75 mg, rifampicin 150mg, pyraziamide 400 mg, and ethambutol 275 mg, the same parameters were reassessed for the patients.
After two months of therapy, there was a significant reduction in the levels of MDA, CRP, and ferritin, with a significant increase in the TAS, serum iron, and transferring saturation percentage with an insignificant effect on the total iron binding capacity in comparison with the patients' pre-therapy values.
Active pulmonary tuberculosis is associated with oxidative stress; the increase in the levels of CRP indicated that pulmonary tuberculosis is associated with an inflammatory response. The initial two months therapy led to significant improvement in oxidative stress and suppression of inflammatory responses. Newly diagnosed cases of pulmonary tuberculosis often had chronic anaemia of inflammation, but this therapy resulted in a significant correction of such anaemia.
本研究的目的是评估急性肺结核的影响以及药物治疗对氧化应激标志物(丙二醛[MDA]和总抗氧化状态[TAS])、C反应蛋白(CRP)和铁代谢状态指标的作用。
本研究纳入了伊拉克摩苏尔市胸部和呼吸疾病咨询诊所的40例活动性肺结核患者,并选取了50名年龄和性别匹配的健康受试者作为对照。对患者和对照者均进行了血清MDA、TAS、CRP、血清铁、总铁结合力、转铁蛋白饱和度百分比和铁蛋白浓度的评估。在给予每日剂量异烟肼75mg、利福平150mg、吡嗪酰胺400mg和乙胺丁醇275mg治疗两个月后,对患者重新评估相同参数。
治疗两个月后,与患者治疗前的值相比,MDA、CRP和铁蛋白水平显著降低,TAS、血清铁和转铁蛋白饱和度百分比显著升高,而对总铁结合力影响不显著。
活动性肺结核与氧化应激有关;CRP水平升高表明肺结核与炎症反应有关。最初两个月的治疗导致氧化应激显著改善和炎症反应受到抑制。新诊断的肺结核病例常伴有慢性炎症性贫血,但这种治疗导致此类贫血得到显著纠正。