The Effect Of Dietary Nutrition Status On Efficiency Of Anti- Tuberculosis Therapy In Patients With Pulmonary Tuberculosis In Linyi

Objective : Dietary nutrition affects the occurrence and development of pulmonary tuberculosis(PTB).The purpose of this study was to explore the effect of dietary nutrition on tuberculosis treatment in patients with pulmonary PTB via collecting the clinical manifestations,nutritional status of the patients and efficiency of anti-tuberculosis,investigating the diversity and levels of dietary nutrition intakes of the PTB patients during treatment.Methods: 2407 patients with pulmonary tuberculosis from 2009 to 2013 were selected from a city in Shandong province.Basic demographic information(age,sex,etc.),life habits(smoking,drinking)and clinical manifestations(symptoms,imaging examination,sputum examination,etc.)and body height and weight were collected.Food frequency table was used to investigate the food types and average daily food consumption level of the subjects in the past years,and the food types consumed in each study during the week were calculated to be 1 point per group of food consumed by dietary diversity score,and the total amount of food consumed in each study group was 1 point per group of food consumed during the past year.Two kinds of food score 2,the highest is 9 points.A 24-hour dietary retrospective method was used to investigate and analyze the recent nutrient intake levels of the patients.The datas were input into the "Nutrition Calculator" module in the software "Family dietitian-Nutrition expert system veil.1(Test Edition)".The energy intake and nutrient contents within 24 hours were calculated.According to the different DDS scores,the subjects were divided into ?3,4~6 and ?7groups.According to the intake amounts of cereal potato,vegetable,livestock meat and all kinds of nutrients,tuberculosis patients were divided into three groups: high intake group,middle intake group and low intake group.The treatment efficiency were divided into cure and uncure according to “The Guidelines for Implementation of China's Tuberculosis Control Program(2008 Edition)”.A multivariate Logistic regression model was established to analyze the effects of dietary diversification and intake of millet potato,vegetable and livestock meat on tuberculosis treatment in patients with pulmonary tuberculosis;1834 people with complete nutrient intake data were selected and the effects of energy and three major productive nutrients vitamin and mineral intake on anti-tuberculosis treatment were analyzed by regression analysis.Result: The results showed that 2407 PTB patients had low weight malnutrition(19.2%)and the mean DDS score was 6.39(43.1%).The proportion of patient with sputum,hemoptysis,fatigue were 83.0%,24.8%,51.1% respectively in patients whose DDS?3.The patients whose lung lesions?4 accounted for 37.6% of the total.All of them were significantly higher than those with DDS 4~6 and ?7(all P<0.05).Nncured PTB patients accounts for 14.9% in patients with DDS?3,which was also significantly higher than that of the other two groups(P< 0.05).Regression analysis showed that the risk of incurability in PTB patients with low body weight malnutrition was 1.467 times higher than that in patients with normal weight,and that in patients with PTB with DDS ? 3 score was 2.289 times higher than that in patients with DDS ? 7 score.The risk of uncured antituberculosis therapy in patients with DDS 4 ? 6 PTB was 1.642 times higher than that in patients with DDS ? 7.The intakes of vegetables,fruits and fish and shrimp in PTB patients were 123.95g/d,45.90g/d and 11.34g/d,respectively,which were lower than the recommended intakes in China.Regression analysis showed that the risk of incurability in PTB patients with livestock meat intake less than 17.61g/kg was 1.574 times higher than that in patients with livestock meat intake?42.86g/d.After the adjustment of age,sex and smoking drinking and BMI,it was 1583 times.The risk of incurable anti-tuberculosis therapy in PTB patients with meat intake less than 10.00g/d was 1.572 times higher than that in patients with meat intake ? 28.57g/d,and 1.623 times after adjusting for confounding factors.The patients who intake enough energy,protein,vitamins and some minerals(such as calcium,magnesium,zinc,selenium,etc.)was less than 50%.The multiple regression analysis of the effect of nutrient intake on tuberculosis treatment in PTB patients showed that the risk of incurability in PTB patients with protein intake less than 52.01g/d was 2.348 times higher than that in patients with protein intake ? 71.50g/d.The risk of incurability in PTB patients with ascorbic acid intake less than 32.00mg/d was 1.650 times higher than that in patients with ascorbic acid intake ? 72.00 mg/d.The risk of incurability in PTB patients with zinc intake less than 7.20 mg/d was 2.722 times higher than that in patients with zinc intake ? 10.20mg/d.Conclusion: The composition of pulmonary tuberculosis patients' diet is relatively simple,the intake of vegetables,fruits,fish and shrimp and multiple mineral is insufficient,and low body weight malnutrition,low level of dietary diversification and livestock,meat,protein,ascorbic acid,Low zinc intake decrease the efficiency of anti-tuberculosis therapy.It is suggested that dietary guidance and nutrient supplement should be used as supplementary therapy in patients with tuberculosis while receiving anti-tuberculosis therapy.