肺结核合并低氧血症或呼吸衰竭患者氧化/抗氧化特点的观察

目的 观察肺结核合并低氧血症或呼吸衰竭患者氧化/抗氧化的特点.方法 采用比色法对20名正常对照者和120例肺结核患者血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GPX)、丙二醛(MDA)进行测定.结果 ①与正常对照者相比,氧合正常的肺结核患者血清SOD、GPX降低(P<0.01,P<0.05),MDA增加(P<0.01).②与氧合正常的肺结核患者相比,合并低氧血症或呼吸衰竭患者的SOD、GPX降低(P<0.01),MDA差异无统计学意义;此外,呼吸衰竭组SOD、GPX和MDA与低氧血症组的差异无统计学意义.③I型和II型呼吸衰竭组SOD、GPX和MDA差异无统计学意义.④当肺结核患者SOD测定值低于x-2s、GPX测定值低于.Z-s、MDA测定值高于x-+2s时,低氧血症或呼吸衰竭的发生率分别为62%(P<0.01)、64%(P<0.01)和59%(P-0.05).logistic回归分析显示GPX降低与低氧血症或呼吸衰竭的发生最为密切相关(P<0.01).结论 血清抗氧化酶活性降低、氧化代谢产物增高是肺结核合并低氧血症或呼吸衰竭患者氧化/抗氧化的特点,而且是导致此合并症的重要机制之一.

Observation of characteristics of oxidative/anti-oxidative in tuberculosis patients accompanied by hypoxemia or respiratory failure

Objective To observe the characteristics of oxidative/anti-oxidative in the tuberculosis (TB)patients accompanied by hypoxemia or respiratory failure.Methods The superoxide dismutase(SOD),glutathione(GPX) and malonaldehyde (MDA) were measured with chromometry in 20 healthy persons and 120 TB patients.ResuIts ①Corrlpared with those of healthy persons,SOD and GPX decreased(P<0.01,P<0.05) and MDA increased(P<0.01)in TB patients with normal oxygenation.②Compared with those of TB patients with normal oxygenation,SOD and GPX decreased(P<0.01) and MDA did not change in TB patients with hypoxemia or respiratory failure.In addition,there were no statistical differences in SOD,GPX and MDA between hypoxemia group and respiratory failure group.③There were no statistical differences in SOD.GPX and MDA between TB patients with I type of respiratory failure and those with Ⅱ type of respiratory failure.④The morbidity of hypoxemia or respiratory failure was 62%,64% and 59% respectively in the patients whose SOD was lower than x-2s or GPX was lower than x-5 or MDA was more than x+2s.Logistic regression analysis showed that GPX was regressive to hypoxemia or respiratory failure.Conclusions The activity of anti-oxidative enzyme decreases,and oxidative products increase,composing the characteristics of oxidative/anti-oxidative in TB patients accompanied by hypoxemia or respiratory failure,both of which is one of the mechanisms resuhing in hypoxemia and respiratory failure.