个体化营养干预对复治肺结核患者营养状况和免疫功能的影响

Influence of individualized nutrition intervention on nutritional status and immune functions of retreated pulmonary tuberculosis patients

目的探讨个体化营养干预对复治肺结核患者营养状况和免疫功能的影响。方法选择2019年1月—2020年12月在右江民族医学院附属医院进行治疗的180例复治涂阳肺结核患者,随机分为对照组和观察组各90例。对照组采取普通饮食,观察组进行个体化营养干预6个月,分别比较两组干预前后各项营养状况指标、细胞免疫指标的变化及临床效果。结果观察组体重指数(BMI)、淋巴细胞计数(LY)、血红蛋白(HGB)、白蛋白(ALB)、前白蛋白(PA)、视黄醇结合蛋白(RBP)干预后及干预前后差值均高于对照组,差异有统计学意义(P<0.05);观察组CD3^(+)T、CD4^(+)T、CD4^(+)/CD8^(+)干预后及干预前后差值均高于对照组,差异有统计学意义(P<0.05);CD8^(+)T细胞干预后及干预前后差值低于对照组,差异有统计学意义(P<0.05);观察组的痰液转阴率和病灶吸收率高于对照组,差异有统计学意义(P<0.01)。结论对复治肺结核患者进行个体化的营养干预,不仅可改善营养状况,增强细胞免疫功能,而且能促进痰液转阴与病灶吸收。

Objective To explore the effect of individualized nutrition intervention on the nutritional status and immune functions of retreated pulmonary tuberculosis patients.Methods 180 retreated smear positive pulmonary tuberculosis patients who were treated in the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2019 to December 2020 were selected,and they were randomly divided into control group and observation group,with 90 cases in each group.The control group were given general diet,while the observation group were given individualized nutritional intervention for 6 months.And then,changes in various nutritional status indicators and cellular immune indicators before and after intervention as well as clinical effects were compared between the two groups.Results Body mass index(BMI),lymphocyte count(LY),hemoglobin(HGB),albumin(ALB),prealbumin(PA),and retinol binding protein(RBP)levels and D-value of them in the observation group were all higher than those in the control group,and difference was statistically significant(P<0.05).CD3^(+)T,CD4^(+)T,CD4^(+)/CD8^(+)and D-value of them in the observation group were all higher than those in the control group,and difference was statistically significant(P<0.05).CD8^(+)T cell and D-value of it in the observation group were all lower than those in the control group,and difference was statistically significant(P<0.05).Sputum negative conversion rate and focus absorption rate of the observation group were higher than those of the control group,and difference was statistically significant(P<0.01).Conclusion Individualized nutritional intervention for retreated pulmonary tuberculosis patients can not only improve the nutritional status,enhance cellular immune functions,but also promote the sputum to turn negative and focus absorption.