肺结核患者低血清蛋白对抗结核治疗生理依从性的影响研究

The effect of the lower albumin to anti-tuberculosis physiological compliance in pulmonary tuberculosis patients

目的了解肺结核患者低血清蛋白对抗结核治疗依从性的影响。方法住院综合治疗2周末,按血清蛋白水平将菌阳肺结核患者分为低血清蛋白组和正常血清蛋白组,设计1M内肝损、1M内肾损、1M后肝损、1M后肾损、更改方案、严重消化道反应和白细胞减少作为抗结核治疗依从性指标对两组患者进行分析比较。结果低血清蛋白组在1月内肝损、1月后肝损、更改方案、严重消化道反应均显著多于正常血清蛋白组。两组之间在1月内肾损、1月后肾损、白细胞减少发生无统计学差异。结论肺结核患者低血清蛋白是引起抗结核药物性肝损(TB-D ILI)的常见原因,因此更改抗结核治疗方案造成患者生理依从性下降,需要对严重低血清蛋白的肺结核患者早期进行营养干预,保证标准抗结核治疗的顺利完成。

Objective To investigate the effect of the low albumin to anti-tuberculosis physiological compliance in pulmonary tuberculosis patients. Method 382 cases smear-positive pulmonary patients were grouped as lower albumin group and normal albumin group according the albumin level. Take the cases of abnormal liver function within 1 month, abnormal renal function within 1 month, abnormal liver function after 1 month, abnormal renal function after 1 month,anti-TB regimen alteration, severe digestive reaction and WBC decline as the makers to evaluate the anti - tuberculosis physiological compliance. The results of the two groups were compared. Results The cases of abnormal liver function within 1 month, cases of abnormal liver function after 1 month, cases of anti-TB regimen alteration and cases of severe digestive reaction were more evidently common in lower albumin group than in normal albumin group. The cases of abnormal renal function within 1 month, cases of abnormal liver function after 1 month, and cases of WBC decline were no evidently difference between the two groups. Conclusion The lower albumin is the most common reason of the （TB-DILI）. The anti-TB regimen should be altered and TB- DILl patients got worse physiological compliance. The lower albumin in TB patients should be corrected by nutritional treatment.