深圳市耐多药结核病人基本营养指标分析  

Analysis of basic nutritional indexes of patients with MDR-TB in Shenzhen

作　　者：季乐财 张乐平[1] 李晓定 邹小飞[1] 吕建文[1] 朴玮 JI Le-cai;ZHANG Le-ping;LI Xiao-ding;ZOU Xiao-fei;LV Jian-wen;PIAO Wei(Department of Tuberculosis,Shenzhen Center for Chronic Disease Control,Shenzhen,Guangdong 518020,China;National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention,Key Laboratory of Trace Element Nutrition of National Health Commission of the People's Republic of China,Beijing 100050,China)

机构地区：[1]深圳市慢性病防治中心结核病科,广东深圳518020 [2]中国疾病预防控制中心营养与健康所,国家卫生与健康委员会微量元素营养重点实验室,北京100050

出　　处：《中国热带医学》2021年第8期791-794,799,共5页China Tropical Medicine

基　　金：深圳市科技创新计划基础研究项目(No.JCYJ20160428145728055);深圳市卫计委科研项目(No.SZXJ2017035);深圳市医疗卫生名工程(No.SZSM201611030,SZSM201611017)。

摘　　要：目的调查深圳市耐多药结核病(multidrug-resistant tuberculosis,MDR-TB)患者一般营养状况,并分析其影响因素,为在MDR-TB病人中开展健康教育和营养干预提供科学依据。方法以2014年6月1日至2018年6月1日深圳市慢性病防治中心结核病门诊收治的MDR-TB病人作为研究对象,面对面调查,建立病人的信息资源库;采用身高体重秤,物理方法测量病人身高、体重,计算体质指数(body mass index,BMI);治疗前抽取病人外周静脉血7 mL,分别送检血红蛋白浓度(hemoglobin concentration,HGB),血清白蛋白浓度(serum albumin concentration,ALB),淋巴细胞绝对值(absolute lymphocyte value,LYM)等。对基本情况、各营养指标采用频数、率等进行统计描述。计量资料进行均数比较,若符合正态分布,选择t检验、Satterthwaite近似t检验或方差分析;若不符合正态分布,选用秩和检验。应用R(3.6.2版本)完成数据可视化。结果229例MDR-TB病人中大部分病人基本营养指标正常,存在少许营养指标偏高状况。营养指标偏低病人中BMI降低最明显,达38.86%(89/229),血红蛋白次之6.55%(15/229),其次为淋巴细胞绝对值2.18%(5/229),白蛋白下降比例最少,仅为0.87%(2/229)。长期饮酒对BMI的影响具有统计学意义(P=0.04),长期饮酒者BMI低于不饮酒者,但在正常范围。性别、长期吸烟、糖尿病等因素对BMI的影响无统计学意义。结论BMI水平在MDR-TB病人营养状态评估中敏感性较高,可作为病人营养状态的整体评估工具;HGB偏低考虑病人铁元素缺乏可能,为进一步检查微量元素提供指导意见;淋巴细胞绝对值偏低提示营养不良及结核病活动期双重可能,为临床治疗提供参考;血清白蛋白在早期MDR-TB病人中降低不明显,如出现明显降低,应积极寻找原因,排除其他疾病。长期饮酒可导致MDR-TB病人营养不良发生率升高,我们应该加强对MDR-TB病人饮酒的干预。Objective To investigate the general nutritional status of multidrug-resistant tuberculosis(MDR-TB)patients in Shenzhen,analyze its influencing factors,and we provide scientific basis for health education and nutritional intervention in MDR-TB patients.Methods The patients with MDR-TB in Shenzhen Center for Chronic Disease Control were selected as the research subjects from June 1,2014 to June 1,2018.The face-to-face investigation was conducted to establish the patient's information resource database.Height and weight scales were used to measure height and weight,and calculate the body mass index(BMI).7 mL of peripheral venous blood was drawn from every patient before treatment and sent for routine blood tests,hemoglobin concentration(HGB),absolute lymphocyte value(LYM),serum albumin concentration(ALB),etc.The frequency and rate of basic situation,each nutritional index were described statistically.The measurement data are compared for the mean.If it meets the normal distribution,choose t test,Satterthwaite approximate t test or analysis of variance.If it does not meet the normal distribution,use the rank sum test.And data visualization was performed by R(version 3.6.2).Results Most of the 229 patients with MDR-TB were of normal basic nutrition status,and there was a slight increase in nutrition indexes.Among patients with decreased nutritional index,BMI decreased the most significantly,reaching 38.86%(89/229),followed by hemoglobin of 6.55%(15/229),and then absolute lymphocyte value of 2.18%(5/229).the albumin decreased the least,only 0.87%(2/229).The effect of long-term drinking on BMI was statistically significant(P=0.04).The BMI of long-term drinkers was lower than that of non-drinkers,but within the normal range.The effects of gender,long-term smoking,and diabetes on BMI were not statistically significant.Conclusion The BMI level is highly sensitive in evaluation of nutritional status of MDR-TB patients and can be used as an overall assessment tool.The decline of HGB considers the possibility of iron deficie

关 键 词：耐多药结核病 营养指标 营养评估 体质指数 

分 类 号：R52[医药卫生—内科学]