肺结核患者营养状况及对抗结核治疗效果影响

Nutritional status of patients with pulmonary tuberculosis and anti-tuberculosis treatment effect

目的了解肺结核患者的营养状况及对常规抗结核治疗效果的影响,为提高肺结核常规治疗疗效提供依据。方法收集2020年4月—2022年4月遂宁市中心医院诊治168例肺结核患者相关资料,采用回顾性分析,以微型营养评定法(Mini Nutritional Assessment,MNA)评分调查患者治疗前营养状况及影响因素,分析无营养风险组与存在营养风险组患者抗结核治疗效果。结果168例患者中,经MNA评分评估为治疗前营养状态良好、存在营养不良风险和营养不良患者分别为64、59和45例。单因素分析,年龄、性别、学历、合并基础疾病和临床症状种类是影响患者治疗前MNA评分因素(t=5.587,4.860,10.219,6.815,3.317,P均<0.05)。多元线性回归分析,结果显示年龄、合并基础疾病、临床症状是影响患者治疗前MNA评分因素(t=3.173,3.718,2.018,P均<0.05),而性别、学历不是影响患者治疗前MNA评分因素(t=0.065,0.059,P均>0.05)。依据患者治疗前MNA评分,将>23.5分与≤23.5分患者分为无营养风险组与营养风险组,无营养风险组和营养风险组的痰菌转阴率和病灶吸收有效率分别为92.19%(59/64)和79.85%(82/104)、90.63%(58/64)和76.92%(80/104),耐药发生率、不良反应率和平均治疗费用分别为7.81%(5/64)和21.15%(12/104)、15.63%(10/64)和31.73%(33/104)、(0.62±0.13)万元和(0.89±0.26)万元,差异均有统计学意义(χ^(2)=5.228,5.071,7.685,5.396,7.728,P均<0.05)。结论肺结核患者治疗前营养状况易受年龄、基础疾病、临床症状等因素影响,且影响患者抗结核治疗效果。患者应及早接受营养干预,以有助于预防患者营养不良和提高患者抗结核治疗疗效。

Objective To investigate the nutritional status of patients with pulmonary tuberculosis and its effects on conventional anti-tuberculosis treatment,so as to provide a basis for improving the efficacy of conventional treatment of pulmonary tuberculosis.Methods The relevant data of 168 patients with pulmonary tuberculosis admitted to Suining Central Hospital from April 2020 to April 2022 were retrospectively analyzed.Nutritional status of the patients before treatment was investigated using the Mini Nutritional Assessment(MNA)score,and the influencing factors of nutritional status before treatment were analyzed.Therapeutic effects of anti-tuberculosis drugs in the non-nutritional risk group and the nutritional risk group were comparatively analyzed.Results Among the 168 patients,64 were assessed as having good nutritional status before treatment,59 had the risk of malnutrition and 45 were malnourished according to the MNA score.Univariate analysis and linear regression analysis showed that age,underlying diseases,and clinical symptoms were factors affecting the MNA score before treatment(t=3.173,3.718,2.018,P all<0.05);whereas gender and education level were not factors affecting MNA score before treatment(t=0.065,0.059,P all>0.05).According to the MNA score before treatment,the patients were divided into a non-nutritional risk group(MNA score>23.5)and a nutritional risk group(MNA score≤23.5).The negative conversion rate of sputum bacteria,effective rate of focal absorption in the non-nutritional risk group were 92.19%(59/64)and90.63%(58/64),respectively,which were significantly higher than corresponding 79.85%(82/104)and76.92%(80/104)in the nutritional risk group.The drug resistance rate,adverse reaction rate,and average treatment cost of the no nutritional risk group and nutritional risk group were 7.81%(5/64)and 21.15%(12/104),15.63%(10/64)and 31.73%(33/104),(0.62±0.13)million yuan and(0.89±0.26)million yuan,respectively,with significant differences(χ^(2)=5.228,5.071,7.685,5.396,7.728,P all<0.05).Conclusions Patients with pulmonary tuberculosis exhibit poor nutritional status before treatment.The patients’nutritional status is easily affected by age,underlying diseases,and clinical symptoms,thereby affecting the effect of anti-tuberculosis treatment.Therefore,early nutritional intervention for tuberculosis patients should be recommended in order to prevent malnutrition and enhance the effectiveness of anti-tuberculosis treatment.