145例复治涂阳肺结核患者血清蛋白等相关指标分析

Analysis of serum protein and other related factors of 145 retreated smear positive tuberculosis patients

目的 分析2012—2013年复治涂阳肺结核患者的营养相关指标，探讨营养不良与复治的相关原因。 方法 对广州市胸科医院第二门诊部辖区内登记的复治涂阳肺结核患者145例和初治涂阳患者105例初诊时血清蛋白、全血红细胞数、血红蛋白进行测定，观察复治涂阳患者首次就诊时的营养状况。将初治涂阳和复治涂阳患者的血清总蛋白、白蛋白、球蛋白、A/G比值、全血红细胞数、淋巴细胞数、血红蛋白数值，采用χ^2检验，P〈0.05为差异有统计学意义。 结果 105例初治涂阳患者中，总蛋白降低者占22.86%（24/105）、白蛋白降低者占20.00%（21/105）、球蛋白降低者占17.14%（18/105）、A/G比值降低者占34.29%（36/105）、红细胞计数降低者占24.76%（26/105）、血红蛋白降低者占47.62%（50/105）、淋巴细胞数降低者占2.86%（3/105）；145例复治涂阳患者中，总蛋白降低者占22.76%（33/145）、白蛋白降低者占22.76%（33/145）、球蛋白降低者占24.83%（36/145）、A/G比值降低者占51.72%（75/145）、红细胞计数降低者占26.90%（39/145）、血红蛋白降低者占33.10%（48/145）、淋巴细胞数降低者占3.45%（5/145）；两组患者A/G比值、血红蛋白降低的率比较，差异具有统计学意义（χ^2值分别为7.502、5.384，P值均＜0.05）；两组患者总蛋白、白蛋白、球蛋白、红细胞计数、淋巴细胞数降低的率比较，差异无统计学意义（χ^2值分别为0.000、0.274、2.124、0.144、0.069，P值均＞0.05）。 结论 血清蛋白A/G比值的降低是结核病复治的高危因素。

Objective This paper work aims to analyze the nutrition of retreated smear positive tuberculosis patients treated in 2012—2013. In addition, the relationship between malnutrition and tuberculosis retreatment was discussed. Methods We observed nutritional status of the retreated smear-positive patients through measurement of serum protein, erythrocyte count, and hemoglobin of 145 cases of retreated smear positive patients and 105 newly diagnosed smear positive patients during their first visit to Guangzhou Thorax Hospital Clinic Ⅱ. The serum total protein, albumin, globulin, A/G ratio, total number of red blood cells, lymphocyte count, hemoglobin values was compared between new and retreatment patients by using Chi-square test, P〈0.05 was considered statistically significant. Results Among 105 new smear-positive patients, the total protein decreased in 22.86% （24/105） of patients, albumin and globulin reduced in 20.00% （21/105） and 17.14% （18/105） of patients respectively, A/G ratio, red blood cell count, hemoglobin and lymph cells reduced in 34.29% （36/105）, 24.76% （26/105）, 47.62%（50/105） and 2.86% （3/105） of the patients respectively; Of the 145 retreated patients, the total protein decreased in 22.76%（33/145）of patients, albumin and globulin reduced in 22.76%（33/145） and 24.83%（36/145） of patients respectively, A/G ratio, red blood cell count, hemoglobin and lymph cells reduced in 51.72%（75/145）, 26.90%（39/145）, 33.10%（48/145） and 3.45%（5/145） of the patients respectively; The decreasing proportion of A/G ratio and hemoglobin is statistically significant different between new and retreated patients （χ^2=7.502, 5.384, P〈0.05）. The decreasing proportion of total protein, albumin, globulin, red blood cell count, lymph cells did not show significant different between two groups（χ^2=0.000,0.274,2.124,0.144,0.069,P〉0.05）. Conclusion Lower serum protein A/G ratio is high risk factor of retreatment of tuberculosis.