血清瘦素与肺结核病患者的营养状况

Relationship between serum leptin levels and nutritional status in patients with tuberculosis.

目的探讨肺结核患者的血清瘦素水平变化与疗效关系。方法对23例初治菌阳肺结核患者,根据其体重指数(BMI)分为慢性能量缺乏组(CED组)及非慢性能量缺乏组(NCED组)。观察抗结核治疗前后的血清瘦素水平及营养状况变化。并以同期在我院健康体检者22例为对照组。结果肺结核组在治疗前LEP、LMP均明显低于对照组,TNF-α明显高于对照组;CED组治疗前LEP、BMI及ALB均明显低于NCED组,而TNF-α明显高于NCED组。肺结核患者强化治疗2个月后,LEP及TNF-α均不同程度的改善;ALB及LMP明显改善。结论肺结核患者处于慢性能量缺乏状态,其血清瘦素水平明显低于健康人,而血TNF-α水平高于健康人;经过2个月的强化治疗后,其蛋白质营养状况改善明显优于能量状况的改善。

Objective To investigate the relationship between the change of serum leptin levels and the curative effect in the patients with tuberculosis for 2-month treatment. Methods The serum leptin levels and nourishment condition before and after anti-tuberculosis treatment were observed in 23 patients of tuberculosis. According to their body mass index, the patients were divided into two groups ： chronic energy deficiency group and non-chronic energy deficiency group. At the same time, 22 healthy persons were in the control group. Results In the tuberculosis group, the levels of serum leptin after treatment were obviously lower than that before treatment （ P = 0. 000）, and the plasma TNF-α in the tuberculosis group was significantly higher than that in the control group （ P =0. 000）. In the chronic energy deficiency group, the levels of serum leptin, albumin and lymphocyte were obviously lower than that in the non - chronic energy deficiency group, but TNF -α was significantly higher than that in the non-chronic energy deficiency group. After two months of the intensive treatment, the serum leptin and levels TNF-etof the tuberculosis patients were improved with various degrees, and the protein nourishment condition was improved obviously also. Conclusion In the tuberculosis patients, there may exist chronic energy deficiency and thus the patients＇ levels of serum leptin were low and their TNF-α was high. After treatment, the improvement of their protein nourishment condition surpasses the improvement of their energy condition.