低胆固醇血症对肺结核合并肺部感染的影响  

Impact of hypocholesterolemia on pulmonary tuberculosis complicated by pneumonia

作　　者：周梦雯[1] 谭守勇[1] 李春燕[1] 陈睿[1] 何婷[1] 

机构地区：[1]广州市胸科医院结核内科,呼吸疾病国家重点实验室,510095

出　　处：《实用医学杂志》2017年第23期3911-3914,共4页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金资助项目(编号:A2016113);广州市科技计划课题(编号:155700012)

摘　　要：目的研究低胆固醇血症对肺结核合并肺部感染的影响。方法收集300例肺结核合并肺部感染患者(观察组)和300例单纯肺结核患者(对照组)的临床资料,比较两组患者年龄、性别、痰菌情况、丙氨酸氨基转氨酶(ALT)、门冬氨酸氨基转氨酶(AST)、血肌酐(Scr)、血尿素氮(BUN)、白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、血清白蛋白(ALB)、血红蛋白(HB)、血淋巴细胞总数(TLC)、血浆总胆固醇(TC)的差异,探讨低胆固醇血症对肺结核合并肺部感染的影响,分析低胆固醇血症与肺炎严重程度(CURB-65评分)的相关性。结果单因素Logistic分析提示低蛋白血症、低淋巴细胞血症、低胆固醇血症是肺结核合并肺部感染的危险因素(P<0.05);多因素Logistic逐步回归分析提示低胆固醇血症是肺结核合并肺部感染的独立危险因素(P<0.05);TC与CURB-65评分存在负相关;肺炎低危组(CURB-65评分为0~1分)、肺炎中危组(CURB-65评分为2分)、肺炎高危组(CURB-65评分为3~5分)TC水平差异有统计学意义(P<0.01)。结论低胆固醇血症是肺结核合并肺部感染的独立危险因素,且胆固醇降低程度与肺炎严重程度相一致。Objective To explore the impact of hypocholesterolemia on pulmonary tuberculosis complicat- ed by pneumonia. Methods The data on 600 patients diagnosed as pulmonary tuberculosis in Guangzhou Chest Hospital were collected. Of the patients, 300 were complicated by pneumonia （study group） , the others were ill with pulmonary tuberculosis alone （control group）. Parameters including age, gender, sputum tubercle bacilli state, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, serum ereatinine （Scr）, blood urea ni- trogen （ BUN ）, hemameba （WBC）, c-reactive protein （ CRP）, proealcitonin （PCT）, serum albumin （ALB）, he- moglobin （HB）, total blood lymphocytes （TLC） , and plasma total cholesterol （TC） between the 2 groups were compared. The correlation between hypoeholesterolemia and the severity of pneumonia estimated by CURB-65 score was analyzed. Results Hypoproteinemia, Hypolymphocyemia and hypocholesterolemia （P 〈 0.05 for all） were identified as risk factors for pneumonia by univariate logistic regression; hypocholesterolemia was confirmed as an independent risk factor in mulitvariate logistic model （P 〈 0.05）. TC concentration was negatively correlated with CURB-65 score and was significantly different among low-risk （CURB-65 score of 0-1） , moderate （CURB-65 score of 2） and high risk （CURB-65 score of 3-5） pneumonia groups （P 〈 0.05 for all）. Conclusions Hypocho- lesterolemia is an independent risk factor for pulmonary tuberculosis complicated by pneumonia. The decreased level of TC is consistent with the severity of pneumonia.

关 键 词：胆固醇 肺结核 肺部感染 影响 

分 类 号：R521[医药卫生—内科学] R563.1[医药卫生—临床医学]