Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India.
J Mol Neurosci. 2019 Jun;68(2):287-294. doi: 10.1007/s12031-019-01304-0. Epub 2019 Apr 11.
Central nervous system infection may be associated with oxidative stress and may influence clinical severity and outcome. We report oxidative stress markers in the patients with tuberculous meningitis (TBM) and correlate these with clinico-radiological severity and outcome. Fifty-six patients with TBM diagnosed on the basis of clinical, cerebrospinal fluid (CSF), and magnetic resonance (MRI) were included. Plasma glutathione (GSH), total antioxidant capacity (TAC), and malondialdehyde (MDA) were measured in the patients and 55 matched healthy controls. Hospital death was noted. Disabilities at 3 and 6 months were categorized using the modified Rankin Scale (mRS) as poor (mRS > 2) or good (mRS ≤ 2). The patients had lower levels of GSH (1.49 ± 0.49 vs 2.57 ± 0.39 mg/dL, p ˂ 0.001) and TAC (0.25 ± 0.17 vs 2.20 ± 0.31 mmol Trolox Eq/L, p ˂ 0.001), and higher level of MDA (6.61 ± 1.72 vs 3.09 ± 0.38 nmol/mL, p < 0.001) compared to controls. Total antioxidant capacity correlated with cranial nerve palsy and CSF pleocytosis. Patients with tuberculoma had lower GSH compared to those without. Six patients died in the hospital, and they had lower GSH (p < 0.01) and TAC (p = 0.02) levels compared to those who survived. Thirty-one and 36 patients had a good outcome at 3 and 6 months respectively. The patients with good outcome had higher GSH level.
中枢神经系统感染可能与氧化应激有关，并可能影响临床严重程度和结局。我们报告了结核性脑膜炎（TBM）患者的氧化应激标志物，并将其与临床-放射学严重程度和结局相关联。根据临床、脑脊液（CSF）和磁共振（MRI）诊断为 TBM 的 56 例患者被纳入研究。测量了患者和 55 名匹配的健康对照者的血浆谷胱甘肽（GSH）、总抗氧化能力（TAC）和丙二醛（MDA）。记录了住院死亡。3 个月和 6 个月时的残疾使用改良 Rankin 量表（mRS）分为不良（mRS>2）或良好（mRS≤2）。与对照组相比，患者的 GSH（1.49±0.49 与 2.57±0.39 mg/dL，p<0.001）和 TAC（0.25±0.17 与 2.20±0.31 mmol Trolox Eq/L，p<0.001）水平较低，MDA（6.61±1.72 与 3.09±0.38 nmol/mL，p<0.001）水平较高。总抗氧化能力与颅神经麻痹和 CSF 白细胞增多有关。与无结核瘤的患者相比，有结核瘤的患者 GSH 水平较低。6 例患者在住院期间死亡，与存活患者相比，他们的 GSH（p<0.01）和 TAC（p=0.02）水平较低。31 名和 36 名患者在 3 个月和 6 个月时分别有良好的结局。预后良好的患者 GSH 水平较高。
