关键词: 老年人, 结核,肺, 营养评价, 对比研究

Abstract:

Objective To investigate the correlation between nutritional risk situation and laboratory test results, length of stay and hospitalization expenses of elderly patients with pulmonary tuberculosis aged ≥65 years. Methods A total of 89 patients ≥65 years old who were diagnosed as pulmonary tuberculosis and admitted in the First Department of Tuberculosis, the Second Hospital of Nanjing from September 1st, 2019 to May 31st, 2020, were screened for nutritional risk according to NRS 2002. On the basis of the NRS score, the patients were divided into two groups with different NRS score: the nutritional risk group (NRS ≥3, 42 cases) and the non-nutritional risk group (NRS <3, 47 cases). At the same time, hemoglobin content, blood lymphocyte count, blood C-reactive protein, blood albumin, blood retinol binding protein, number of pulmonary lobes involved in chest CT at the beginning of admission, days of hospitalization and its cost were collected, and the indexes of two groups were compared. Linear correlation analysis was used for correlation analysis between NRS 2002 score and the observed indexes. Results The hemoglobin of the 47 patients in non-nutritional risk group was (124.4±21.8) g/L, hemolyte number was 1.3 (0.9, 1.8) ×10 ⁹/L, serum albumin was (37.5±4.5) g/L, hemretinol binding protein was 28.7 (23.2, 35.0) g/L, which were significantly higher than those of the nutrition risk group ((108.0±18.3) g/L, 0.9 (0.6, 1.2)×10⁹/L, (34.9±5.0) g/L and 18.4 (13.8, 28.0) g/L) (t=3.834, P<0.001; Z=3.017, P=0.003; t=2.602, P=0.011; Z=3.846, P<0.001). C-reactive protein was 5.7 (2.4, 15.0) mg/L and hospitalization expenses were 19163.4 (15293.1, 24597.5) yuan, which were significantly lower than those of the nutrition risk group (35.3 (6.0, 76.9) mg/L and 22022.1 (18298.7, 29410.2) yuan) (Z=3.090, P=0.002; Z=2.367, P=0.018). There was no significant difference in the number of pulmonary lobes involved (5 (5, 5)), length of stay (14 (11, 21) d) between patients with nutritional risk and those without nutritional risk (5 (3, 5), 15 (12, 22) d) (Z=0.892, P=0.372; Z=1.182, P=0.237). Nutritional risk was negatively correlated with hemoglobin, blood lymphocyte count, serum albumin and serum retinol binding protein (correlation coefficients were -0.419, -0.240, -0.308 and -0.392, P values were <0.001, 0.024, 0.003 and <0.001 respectively), and positively correlated with C-reactive protein and hospitalization expenses (correlation coefficient were 0.226, 0.279, P values were 0.033, 0.008). Conclusion Patients with nutritional risk are more likely to develop anemia, decreased lymphocyte count, hypoalbuminemia, infection, decreased retinol binding protein, and increased hospitalization costs.

Key words: Aged, Tuberculosis,pulmonary, Nutrition assessment, Comparative study