Jack C I, Jackson M J, Hind C R
Department of Medicine, Royal Liverpool University Hospital, UK.
Tuber Lung Dis. 1994 Apr;75(2):132-7. doi: 10.1016/0962-8479(94)90042-6.
Toxic free radicals have been implicated in the development of lung fibrosis which may be a long-term sequela of pulmonary tuberculosis.
To measure circulating indicators of free radical activity in patients with pulmonary tuberculosis in order to determine whether patients with active pulmonary TB have elevated levels of circulating free radical activity, and whether these levels correlated with disease activity as determined by other blood markers of inflammation.
17 patients with active pulmonary tuberculosis were studied. Serial serum levels of 3 assays of free radical activity were measured at diagnosis (17 patients), and over a 2-7 month period on chemotherapy (8 patients). 3 patients with active lymph node tuberculosis were also studied and 4 patients with old lung scarring from previously treated tuberculosis had their serum markers analysed.
All 3 serum markers of free radical activity were elevated in patients with active pulmonary tuberculosis. During serial measurement in 8 patients the % molar ratio of 9,11 linoleic acid/9,12 linoleic acid fell progressively with treatment. Thiobarbituric acid reactive substances (TBARS) were initially elevated in 6/8 patients and remained elevated despite treatment. In 2 patients TBARS were in the normal range at presentation but subsequently rose with treatment. Desferrioxamine-chelatable iron was initially normal in all but 1 patient, remained normal in 2 patients, rose in 4 patients and fell in 1 patient.
These results suggest that increased circulating levels of free radical activity are found in active pulmonary tuberculosis and hence may play a role in the resultant fibrosis. It also reinforces the belief that a range of free radical activity (FRA) indicators are produced in any inflammatory process with fibrogenic potential and that these indicators may be measuring different stages of the disease process.
有毒自由基与肺纤维化的发生有关，肺纤维化可能是肺结核的长期后遗症。
测量肺结核患者循环中自由基活性指标，以确定活动性肺结核患者循环中自由基活性水平是否升高，以及这些水平是否与由其他炎症血液标志物所确定的疾病活动度相关。
对17例活动性肺结核患者进行研究。在诊断时（17例患者）以及化疗2至7个月期间（8例患者），连续测定3种自由基活性检测指标的血清水平。还对3例活动性淋巴结结核患者进行了研究，并分析了4例既往肺结核治疗后遗留陈旧性肺瘢痕患者的血清标志物。
活动性肺结核患者的所有3种自由基活性血清标志物均升高。在对8例患者的连续测量中，9,11-亚油酸/9,12-亚油酸的摩尔百分比随着治疗逐渐下降。硫代巴比妥酸反应性物质（TBARS）在6/8例患者中最初升高，尽管接受了治疗仍保持升高。2例患者在就诊时TBARS在正常范围内，但随后随着治疗而升高。除1例患者外，其余患者血清去铁胺可螯合铁最初均正常，2例患者保持正常，4例患者升高，1例患者下降。
这些结果表明，活动性肺结核患者循环中自由基活性水平升高，因此可能在由此导致的纤维化中起作用。这也强化了这样一种观点，即在任何具有纤维化潜能的炎症过程中都会产生一系列自由基活性（FRA）指标，并且这些指标可能在测量疾病过程的不同阶段。
