中国防痨杂志2026，Vol.48Issue(5)：631-640,10.DOI:10.19982/j.issn.1000-6621.20250422
代谢相关脂肪性肝病对初治肺结核患者抗结核治疗短期疗效影响因素
Influence factors of metabolic dysfunction-associated fatty liver disease on short-term effectiveness of anti-tuberculosis therapy in primary pulmonary tuberculosis patients
摘要
Abstract
Objective:To explore the impact and influencing factors of metabolic dysfunction-associated fatty liver disease(MAFLD)on short-term effectiveness of anti-tuberculosis treatment in patients with newly diagnosed pulmonary tuberculosis(PTB),to provide a theoretical basis for individualized treatment of PTB patients.Methods:A case-control study was conducted,enrolling 320 newly diagnosed PTB patients admitted to Nanjing Second Hospital,Jiangsu Province from January to December 2023.According to the effectiveness at the end of the 2nd month of anti-tuberculosis treatment,the patients were divided into a favorable effectiveness group(146 cases)and a poor effectiveness group(174 cases).Demographic characteristics,metabolic indicators(including blood lipids,blood glucose,hepatic steatosis,etc.)and clinical data of the patients were collected.Uni variable analysis was used to screen metabolic indicators related to treatment effectiveness,and multivariable logistic regression analysis was performed to identify factors influencing treatment effectiveness.Results:Univariable analysis revealed that in the poor-response group,42.0％(73/174)of patients had a body mass index(BMI)＞24 kg/m2,54.0％(94/174)had concomitant diabetes,hypertension(52/174,29.9％),and hepatic steatosis(103/174,59.2％).These proportions all were significantly higher than those in the good response group(24.7％(36/146),17.1％(25/146),15.1％(22/146),and 12.3％(18/146),respectively;x2 values:17.739,46.276,9.803,74.155;P＜0.05 for all).Multivariable analysis indicated that abnormal triglycerides(OR=6.179,95％CI:3.159-12.312),abnormal high-density lipoprotein cholesterol(OR=2.134,95％CI:1.233-3.586),and complicated diabetes mellitus(OR=4.412,95％CI:2.464-7.666)were independent risk factors for poor anti-tuberculosis treatment effectiveness.Patients who met the diagnostic criteria for MAFLD had a significantly increased risk of poor treatment effectiveness(OR=11.15,95％CI:6.04-20.57).Conclusion:Abnormal triglycerides,abnormal high-density lipoprotein cholesterol,and concomitant diabetes mellitus are independent risk factors for poor anti-tuberculosis treatment effectiveness.MAFLD is an important factor affecting the prognosis of PTB.Clinically,enhanced monitoring and management should be implemented for PTB patients complicated with MAFLD.关键词
结核,肺/脂肪肝/代谢综合征X/危险因素Key words
Tuberculosis,pulmonary/Fatty liver/Metabolic syndrome X/Risk factors分类
医药卫生引用本文复制引用
黄俊,杜志祥,胡春梅..代谢相关脂肪性肝病对初治肺结核患者抗结核治疗短期疗效影响因素[J].中国防痨杂志,2026,48(5):631-640,10.基金项目
江苏省传染病医学创新中心(CXZX202232) （CXZX202232）
江苏省"333高层次人才培养工程"(2022-3-1-272) Jiangsu Provincial Center for Innovation in Infectious Disease Medicine(CXZX202232) （2022-3-1-272）
Jiangsu Province'333 High-Level Talent Cultivation Program'(2022-3-1-272) （2022-3-1-272）
