农村结核病患者与健康人群营养素摄入及食物多样化水平对比分析

Comparative Analysis of Nutrient Intake and Food Diversification Levels of Tuberculosis Patients and Healthy Population in Rural

目的:膳食营养可影响结核病发生发展和预后,本文调查结核病患者膳食营养素摄入状况及存在的问题,为指导患者合理营养膳食提供科学依据。方法:选取某农村地区结核病患者1 955人为病例组,正常人群1 955人为对照组,两组人群进行了良好的匹配,平均年龄、性别比例相近,生活习惯及家庭条件相似。应用食物频率表收集调查对象消费的食物种类,24h膳食回顾法收集调查对象膳食营养素摄入情况。结果:膳食调查结果显示,结核病患者每日能量和蛋白质摄入量分别为1 712kcal和65.73g,仅达到推荐摄入量的71.33%和87.64%,且明显低于健康对照组人群的1 855kcal(P<0.001)和70.36g(P<0.001);一些维生素及矿物质每日摄入量也明显不足,其中结核病患者视黄醇和钙的摄入量仅分别为320.59μg视黄醇当量和295.69mg,为推荐摄入量40.08%和36.96%,也明显低于对照组平均水平(P均小于0.0001)。膳食多样化评分(DDS)结果显示,两组人群DDS评分均为6.31,日常饮食能保持7种及以上食物组成的人数比例病例组和对照组分别可达到52.94%和49.16%;而有5.78%结核病患者得分仅为3分,即日常饮食的食物种类只有3类,明显高于对照组人群的2.66%;2.10%结核病患者得分仅为2分,也明显高于对照组的1.18%,表明结核病患者膳食单调或种类单一。食物消费种类结果显示,结核病患者食物以谷类为主,可达90%以上,鱼虾类和奶类消费率低,仅为23.38%和37.08%;同样的问题也存在于对照组人群。结论:农村结核病患者及健康人群能量、视黄醇、钙等营养素摄入量偏低,结核病患者不足更为突出,与膳食不平衡有关;建议积极改善营养及膳食结构,有效防治结核病。

[Objective] Diet nutrition can affect the development and prognosis of tuberculosis（TB）. This article surveyed the dietary nutrients intake condition of TB patients to provide a reasonable scientific basis for diet nutritional guidance and health promotion to the tuberculosis patients. [Method] Totally 1 955 patients with tuberculosis in rural areas were selected as the case group, 1955 normal people as the control group. These two groups were well matched, and the average age, gender ratio, lifestyle and the family conditions were similar. Collect food types using the investigation of dietary frequency and collect the dietary intake by recall method of 24h food intake. [Result] The daily energy and protein intakes of TB patients were 1 712 kcal and 65.73g, only 71.33% and 87.64% of the Recommended Nutrient Intakes, and were significantly lower than the healthy control group population 1 855 kcal （P 〈0.001） and 70.36g （P 〈0.001）. Some of the daily intakes of vitamins and minerals were clearly inadequate, the intakes of retinol and calcium in TB patients were only 320.59 ~t g retinol equivalent and 295.69mg, only 40.08% and 36.96% of the Recommended Nutrient Intakes, and were significantly lower than the average levels of the control group （P〈0.0001）. Dietary Diversity Score （DDS） showed that two groups DDS were 6.31, the daily diet could maintain 7 or more kinds of food composition ratio in cases and control groups, respectively, up to 52.94% and 49.16% . However, 5.78% of TB patients got 3 points, which meaned the types of food only 3 categories, significantly higher than control group population 2.66% , 2.10% of TB patients scored only 2 points, also significantly higher than control group population 1.18% , which indicated that the diet of TB patients was monotonous. Types of food consumption showed that food to TB patients was cereal-based, more than 90% , fish and shrimp and milk consumption was low, only 23.38% and 37.08% . The same problem also existed in the control group population. [Conclusion] Energy, retinol and calcium intakes were low in TB patients and healthy people in rural areas, which was more prominent for TB patients, and this was related with dietary imbalances. Diet structure should be improved for TB patients.