【摘要】 目的：研究大剂量异烟肼四联抗结核方案对初治活动性肺结核（NTAPT）患者炎症因子、氧化应激、结核相关蛋白的影响。方法：选取2023年1月～2024年3月于某院治疗的NTAPT患者216例作为研究对象，采用随机数字表法分为观察组和对照组，每组108例。对照组行常规四联方案治疗，观察组行大剂量异烟肼四联抗结核方案治疗。观察治疗前后两组患者血清白介素-6(IL-6)、白介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)等炎症因子水平；血清总抗氧化态（TAS）、总氧化态（TOS）水平及氧化应激指数（OSI）等氧化应激指标；血清γ-干扰素诱导蛋白10(IP-10)、巨噬细胞炎症蛋白-1α(MIP-1α)、单核细胞趋化蛋白-1(MCP-1)等结核相关蛋白指标水平，以及临床疗效及不良反应发生情况。结果：治疗后，两组患者IL-6、IL-10、TNF-α、TOS、OSI、IP-10、MIP-1α、MCP-1水平均降低，且观察组低于对照组；血清TAS水平均升高，且观察组高于对照组。观察组临床治疗总有效率（93.52%）高于对照组（81.48%,P<0.05）；两组患者不良反应总发生率比较无统计学差异（P>0.05）。结论：大剂量异烟肼四联方案可有效提高临床疗效，抑制炎症反应及氧化应激，下调结核相关蛋白表达，且不会增加不良反应发生风险。更多还原

【Abstract】 Objective: To investigate the efficacy of high-dose isoniazid quadruple anti-tuberculosis regimen in the treatment of newly treated active pulmonary tuberculosis(NTAPT) and its effects on inflammatory factors, oxidative stress, and tuberculosis-related proteins. Methods: A total of 216 NTAPT patients treated in a hospital from January 2023 to March 2024 were enrolled and randomly divided into the observation group(n=108, high-dose isoniazid quadruple regimen) and the control group(n=108, conventional quadruple regimen). Before and after treatment, serum levels of inflammatory factors [interleukin-6(IL-6), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α)], oxidative stress indices [total antioxidant state(TAS), total oxidative state(TOS), oxidative stress index(OSI)], and tuberculosis-related proteins [γ-interferon-induced protein 10(IP-10),macrophage inflammatory protein-1α(MIP-1α), monocyte chemoattractant protein-1(MCP-1)]were measured. Clinical efficacy and adverse drug reactions were also evaluated. Results: After treatment, serum levels of IL-6, IL-10, TNF-α, TOS, OSI, IP-10, MIP-1α, MCP-1, decreased in both groups, with significantly lower levels in the observation group than in the control group(P all <0.05). Conversely, serum TAS levels increased significantly in both groups, with higher levels in the observation group(P<0.05). The total effective rate was 93.52% in the observation group,significantly higher than 81.48% in the control group(P<0.05). No significant difference in adverse drug reaction rates was observed between the two groups(P>0.05). Conclusion: The high-dose isoniazid quadruple regimen effectively improves clinical efficacy, inhibits inflammatory response and oxidative stress, downregulates tuberculosis-related protein expression, and does not increase the risk of adverse reactions in NTAPT treatment.更多还原