肺结核并营养不良患者体成分特点的研究  

Study on the body composition of patients with pulmonary tuberculosis and malnutrition

作　　者：林媛[1] 谭守勇[1] 蔡琼娣 沈惠兰[1] 彭德虎[1] 谭小梅 梁雯丽 刘玉群 LIN Yuan;TAN Shou-yong;CAI Qiong-di;SHEN Hui-lan;PENG De-hu;TAN Xiao-mei;LIANG Wen-li;LIU Yu-qun(Department of Internal Medicine-Tuberculosis,Guangzhou Chest Hospital,State Key Laboratory of Respiratory Disease,Guangzhou 510095,Guangdong,China)

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

出　　处：《广东医学》2021年第4期382-385,共4页Guangdong Medical Journal

基　　金：广州市科技计划项目(155700012);广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]1555号)。

摘　　要：目的探讨肺结核并营养不良患者体成分的特点,为临床开展营养支持治疗提供参考。方法对住院的100例肺结核患者进行人体成分分析测定并完善血清蛋白、血脂检测和胸部CT等检查。根据体质指数(BMI)分为营养不良组(BMI<18.5 kg/m^(2))和非营养不良组(BMI≥18.5 kg/m^(2))。结果(1)两组患者肺影像学病灶范围差异有统计学意义(P<0.01)。肺部病灶范围≥5个肺野相对肺病灶范围≤2个肺野发生营养不良的风险增加(OR=3.472,95%CI:1.253~9.624)。营养不良组肺部出现空洞者高于非营养不良组,差异有统计学意义(P<0.001)。(2)营养不良组在体成分测定中的身体水成分、蛋白质、肌肉量、体脂肪重量、体脂肪率均低于非营养不良组,差异有统计学意义,(P<0.05)。(3)人体成分蛋白质量与血清白蛋白之间差异无统计学意义(P>0.05)。体脂肪重量与血清三酰甘油、总胆固醇之间存在线性相关(P<0.05)。结论肺结核并营养不良患者其身体水成分、蛋白质、肌肉量、体脂肪重量等均较非营养不良患者出现下降,肺部病灶广泛及空洞较多。人体成分分析具有操作简单、无创、经济、快捷、可信度高等优点,可帮助我们对结核患者营养状态进行初步筛查并根据其结果给予营养支持治疗。Objective To investigate the body composition of patients with pulmonary tuberculosis and malnutrition,and provide references for clinical nutrition support treatment.Methods A hundred cases of pulmonary tuberculosis hospitalized in the Department of Tuberculosis of Guangzhou Chest Hospital were selected.Patients received body composition analysis as well as assessment on serum albumin,blood lipids and chest CT examinations.According to the body mass index(BMI),patients were divided into malnutrition group(BMI<18.5 kg/m^(2))and non-malnutrition group(BMI≥18.5 kg/m^(2)).Results There was statistically significant difference in the range of lung imaging lesions between the two groups(P<0.01).The risk of malnutrition was increased as lung lesions≥5 lung fields,when compared to those with lung lesions≤2 lung fields(OR=3.472,95%CI:1.253-9.624).The number of cavities in the lungs of the malnourished group was significantly morethan that of the non-malnourished group(P<0.001).The body composition measurements including body water composition,protein,muscle mass,body fat weight,and body fat rate of the malnutrition group were significantly lower than those of the non-malnourished group(P<0.05).There was no significant difference in the quality of human body protein and serum albumin between the two groups(P>0.05).There were linear correlations of body fat weight with serum triglycerides and total cholesterol(P<0.05).Conclusion With the advantages of simple operation,non-invasive,economical,fast,and high reliability,body composition analysis can help clinicians to conduct preliminary screening of the nutritional status of tuberculosis patients and provide nutritional support treatment based on the results.

关 键 词：肺结核 营养不良 人体成分 

分 类 号：R521[医药卫生—内科学] R723.13[医药卫生—临床医学]