中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (7): 741-746.doi: 10.3969/j.issn.1000-6621.2020.07.018
姜丽*, 张晓强, 刘伶俐, 王晗, 刘峰, 李智越, 沈生荣()
收稿日期:
2020-03-02
出版日期:
2020-07-10
发布日期:
2020-07-09
通信作者:
沈生荣
E-mail:shenshengrongzju@163.com
JIANG Li*, ZHANG Xiao-qiang, LIU Ling-li, WANG Han, LIU Feng, LI Zhi-yue, SHEN Sheng-rong()
Received:
2020-03-02
Online:
2020-07-10
Published:
2020-07-09
Contact:
SHEN Sheng-rong
E-mail:shenshengrongzju@163.com
摘要:
营养不良是活动性结核病患者的常见结局之一,也是结核病患者早期死亡的危险因素。若不加以干预,结核病与营养不良间会形成一种恶性循环,导致结核病患者临床症状更为严重,治疗不良事件发生率更高,患者死亡风险更高。随着中国居民平均生活水平的提高及临床营养学的发展,对于结核病患者的营养管理,也逐渐开始重视起来。为更有针对性地设计营养补充方案,首先需要明确结核病患者各类营养素缺乏的具体情况。作者通过对国内外结核病营养研究现状进行分析,综合阐述了结核病患者宏量营养素、维生素和矿物质等各类营养素缺乏的临床特征,梳理了结核病患者的营养支持治疗思路,提出了各营养素的补充目标。
姜丽, 张晓强, 刘伶俐, 王晗, 刘峰, 李智越, 沈生荣. 结核病患者营养素缺乏临床特征研究进展[J]. 中国防痨杂志, 2020, 42(7): 741-746. doi: 10.3969/j.issn.1000-6621.2020.07.018
JIANG Li, ZHANG Xiao-qiang, LIU Ling-li, WANG Han, LIU Feng, LI Zhi-yue, SHEN Sheng-rong. Research progress of clinical characteristics of malnourished patients with tuberculosis[J]. Chinese Journal of Antituberculosis, 2020, 42(7): 741-746. doi: 10.3969/j.issn.1000-6621.2020.07.018
表1
蛋白质和能量补充对结核病治疗的影响
文献第一作者 (年份) | 国 别 | 补充营 养类型 | 受试者 | 样本量 (例) | 饮食结构 | 结果 |
---|---|---|---|---|---|---|
Paton(2004)[ | 新 加 坡 | 蛋白质、 能量 | 成年结核病患者,体质量指数(BMI)<20 | 36 | 补充治疗组:建议饮食标准,额外添加含2510~3766kJ的安素(含25~37.5g蛋白质),为期6周 对照组:建议饮食标准,为期6周 | 补充治疗组与对照组在第12周均出现体质量增加,分别为2.6kg和0.8kg;体质量和握力增加 |
Martins(2009)[ | 东 帝 汶 | 蛋白质、 能量 | 成年结核病患者,80%的患者BMI<18.5 | 270 | 补充治疗组:建议饮食标准,额外添加含1799kJ的肉类(含18g蛋白质),2个月院内+6个月居家 对照组:建议饮食标准,2个月院内+6个月居家 | 补充治疗组与对照组在第8周体质量分别增加5.2kg和3.5kg |
Sudarsanam(2011)[ | 印 度 | 蛋白质、 维生素、 微量元素、 能量 | 成年结核病患者,BMI≤19,其中22例患者并发HIV感染,CD4+ T淋巴细胞≤200 个/μl | 103 | 建议饮食标准,额外添加谷物和豆类混合物,能量约为3891kJ,蛋白质含量约31.5g,为期6个月 对照组:建议饮食标准,为期6个月 | 组间结果差异无统计学意义,但补充治疗组的结核病及结核病并发HIV感染者都有改善的趋势 |
Jahnavi(2010)[ | 印 度 | 蛋白质、 维生素、 微量元素、 能量 | 成年结核病患者,BMI≤20 | 100 | 建议饮食标准,额外添加糖丸(一种补充能量的食物;含2510kJ能量和6g蛋白质),100g的坚果(用于补充维生素和矿物质),为期3个月 对照组:建议饮食标准,为期3个月 | 补充治疗组与对照组在第3个月均出现较为明显的体质量增加,分别为3.7kg 和1.1kg |
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