新发传染病电子杂志2025，Vol.10Issue(3)：12-17,6.DOI:10.19871/j.cnki.xfcrbzz.2025.03.003
耐药肺结核患者营养和免疫状态与结核病严重程度的关系
The relationship between nutritional and immune status and severity of drug-resistant pulmonary tuberculosis
摘要
Abstract
Objective To investigate the relationship between nutritional and immune indicators and the severity of drug-resistant pulmonary tuberculosis(DR-TB),and to provide a basis for developing precision intervention strategies based on nutritional and immunomodulatory approaches.Method This cross-sectional study enrolled 336 patients diagnosed with DR-TB and admitted to Guangzhou Chest Hospital from January to December 2023.Based on pulmonary imaging features,patients were divided into a severe DR-TB group(≥3 infected lung fields,n=183)and a general DR-TB group(＜3 infected lung fields,n=153).Nutritional status was assessed using body mass index(BMI),nutritional risk screening score(NRS-2002),total protein(TP),prealbumin(PA),trans iron protein(TRF),serum albumin(ALB)levels and prognostic nutritional indicator(PNI),immune status was evaluated via CD4+T,CD8+T,CD3+T,as well as white blood cells(WBC),neutrophil(Neu),lymphocyte(LYM)count,platelets(PLT),neutrophil to lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR).Multivariate logistic regression was used to assess the relationship between nutrition,immune status and DR-TB severity.Result Compared with patients in the general DR-TB group,patients in the severe DR-TB group were more likely to be middle-aged and older men with a longer course of disease(P＜0.05).In nutritional index,BMI,PNI,ALB,PA and TRF levels were significantly lower in the severe DR-TB group(all P＜0.05).In terms of immune indexes,severe DR-TB patients exhibited reduced CD4+T,CD3+T and LYM levels but elevated WBC,PLT,NLR and PLR levels,with higher proportions of abnormal WBC,LYM,and NLR results,P＜0.05.Multivariate logistic regression analysis showed that BMI,PNI,ALB and PA were protective factors against severe DR-TB,while WBC,Neu,PLT,NLR,and PLR were independent risk factors,after adjusting for age,gender,BMI,diabetes mellitus and disease duration.Conclusion Nutrition and immune status are significantly associated with the severity of DR-TB.Effective infection control,improved nutritional status,and enhanced immune function may help reduce the risk of severe DR-TB and thus improve patient prognosis.关键词
耐药肺结核/营养状况/免疫功能/严重程度/预后营养指数Key words
Drug-resistant pulmonary tuberculosis/Nutritional status/Immune function/Severity/Prognostic nutritional indicators分类
医药卫生引用本文复制引用
卢春丽,李艳,汪敏,袁园,黄亚玲,范佳画..耐药肺结核患者营养和免疫状态与结核病严重程度的关系[J].新发传染病电子杂志,2025,10(3):12-17,6.基金项目
1.广州国家实验室专项(GZNL2024A01030) （GZNL2024A01030）
2.广州市科学技术局基础研究计划(2025A03J3707) （2025A03J3707）
3.广州市科技计划(2024B03J1345) （2024B03J1345）
