| Tuberculosis(TB)is an infectious disease mainly caused by mycobacterium tuberculosis.It has the characteristics of high infection rate,high morbidity and high mortality,and is widespread in the world.With the continuous invention and use of anti-tb chemical drugs such as streptomycin,the application of BCG vaccine,and the attention of governments,tuberculosis was once effectively controlled.However,in recent years,with the rapid development of information and technology,the economies of all countries in the world have also shown a trend of rapid growth,resulting in a dramatic increase in population mobility,greatly increasing the possibility of the spread of tuberculosis;In addition,with the increase of the number of passage,BCG vitality gradually decreased;As well as the unreasonable use of anti-tuberculosis drugs in clinical practice,leading to the rise of the trend of tuberculosis epidemic.The rapidly growing economy has made mobile phones cheaper and more versatile,making them widely available around the world.With the widespread application and popularization of mobile phones,the problem of mobile phone dependence is increasingly prominent,which has been widely concerned by many scholars in the academic circle.Some studies have found that mobile phone dependence is an independent risk factor for tuberculosis,but its specific effect on TB patients and its mechanism of action are still unclear.Therefore,this study takes mobile phone dependence as the entry point,mainly discusses the influence of mobile phone dependence on tuberculosis patients and its possible mechanism of action,so as to provide some reference for the prevention and control of tuberculosis.Objective:Through the analysis of mobile phone depends on clinical symptoms in patients with pulmonary tuberculosis,image data,nutrition index,the influence of inflammatory,bacteria and the immune indexes,discover phone depends on the effect oftuberculosis patients and its possible mechanism,to strengthen the medical staff and patients and management,to the attention of the mobile phone depend on for tuberculosis prevention and control strategies and measures for improvement to provide relevant reference.Method:The research object of this study selected in January 2019 to December2019 at the beginning of the second people's hospital diagnosis of yan 'an secondary active tuberculosis,young people aged between 15 and 34 years old patients,132 cases(male 79,female 53),use a mobile phone dependencce index scale(MPAI)on the group of patients questionnaire survey,according to the mobile phone addiction index scale score of tuberculosis patients divided into dependent group(MPAI score 51 points or higher),no mobile phone rely on group(MPAI score < 51 points)in the two groups.1.General information(sex,age,smoking history,drinking history);2.Clinical symptoms:fever,night sweats,cough,hemoptysis,chest pain,shortness of breath;3.Imaging data:including the scope of lesion involvement,the presence or absence of cavity,and the presence or absence of pleural effusion;4.Detection indicators: nutritional indicators:body mass index(BMI),total protein(TP),albumin(ALB),pre-albumin(PA);Inflammatory indicators: WBC,procalcitonin(PCT),c-reactive protein(CRP),ESR;Bacterial indicators: sputum smear positive rate;(4)immune indicators: CD3+ T lymphocyte level,CD4+ T lymphocyte level,CD8+ T lymphocyte level,CD4+/CD8+ratio.SPSS 22.0 software package was used to compare the differences of each index between the two groups by independent sample t test and chi-square test.Pearson correlation test was used to analyze the correlation between MPAI score and immunological indexes.Results:1.Comparison of general data of the two groups of patients: there was no difference in gender,age,smoking history and drinking history between the two groups(P > 0.05).2.Comparison of clinical symptoms between the two groups: the proportion ofcough and shortness of breath in the cell-phone-dependent group was higher than that in the cell-phone-free group(P < 0.05),and there was no difference in fever,night sweats,hemoptysis and chest pain between the two groups.3.Comparison of the image data of the two groups of patients: the range of lesions in the mobile phone-dependent group was more extensive than that in the non-mobile phone-dependent group(P < 0.05);There was no difference in the incidence of cavitation and pleural effusion between the two groups(P > 0.05).4.Comparison of nutritional indicators between the two groups: the ALB and PA levels of pulmonary tuberculosis patients in the mobile phone dependent group were lower than those in the non-mobile phone dependent group(P < 0.05).There was no difference in BMI and TP between the two groups(P > 0.05).5.Comparison of inflammatory indicators between the two groups: CRP and ESR were higher in the cell-phone dependent group than in the cell-phone independent group(P < 0.05),and there was no difference in WBC and PCT levels between the two groups(P > 0.05).6.Comparison of bacterial indicators between the two groups: there was no difference in sputum positive rate between the two groups(P > 0.05).7.Comparison of immune indicators between the two groups: the ratio of CD4+T lymphocytes and CD4+ /CD8+ in the cell-phone dependent group was lower than that in the cell-phone dependent group(P < 0.05),and the level of CD8+T lymphocytes was higher than that in the cell-phone dependent group(P <0.05).There was no difference in CD3+ T lymphocyte levels between the two groups(P > 0.05).8.Pearson correlation test was used to analyze the correlation between MPAI score and T cell immune indicators.It was found that the correlation coefficient r between MPAI score and CD3+T lymphocytes,CD4+T lymphocytes,and CD4+/CD8+ ratios were-0.024,-0.423,and-0.422,respectively,with P < 0.05,indicating statistically significant differences.The correlation coefficient r betweenMPAI score and CD8+T cells was 0.120,P > was 0.05,and the difference was not statistically significant.It can be considered that MPAI score is negatively correlated with CD4+T cells and CD4+/CD8+ ratio to a moderate degree,but has no correlation with CD3+T cells and CD8+T cells.9.Pearson correlation test was used to analyze the correlation between each immune index and inflammatory index.It was found that the correlation coefficient r between CD3+T lymphocyte level and WBC was-0.159,P > was 0.05,and the difference was not statistically significant.The correlation coefficient r between CD3+T lymphocyte level and PCT,CRP and ESR was-0.399,-0.631 and-0.479,respectively(P < 0.05),and the difference was statistically significant.The correlation coefficient r between the level of CD4+T lymphocytes and WBC,PCT,CRP and ESR was-0.183,-0.415,-0.529 and-0.362,respectively(P < 0.05),and the difference was statistically significant.The correlation coefficient r between CD8+T lymphocyte level and WBC was 0.141,P > was 0.05,and the difference was not statistically significant.The correlation coefficient r between CD8+T lymphocyte level and PCT,CRP and ESR was 0.312,0.666 and 0.513,respectively(P < 0.05),and the difference was statistically significant.The correlation coefficient r between CD4+/CD8+T lymphocytes and WBC was-0.165,P > was 0.05,and the difference was not statistically significant.The correlation coefficient r between CD4+/CD8+T lymphocyte level and PCT,CRP and ESR was-0.376,-0.587 and-0.419,respectively(P < 0.05),and the difference was statistically significant.In addition to WBC,all inflammatory indicators were negatively correlated with CD3+T lymphocyte level,CD4+T lymphocyte level,and CD4+/CD8+T lymphocyte level to a moderate degree,and positively correlated with CD8+T lymphocyte level to a moderate degree.10.Spearman correlation test was used to analyze the correlation between lesion range and various immune indicators,and it was found that the correlation coefficient r between lesion range and CD3+ t-lymphocyte percentage,CD4+t-lymphocyte percentage and CD4+/CD8+ ratio were-0.382,-0.331 and-0.306,respectively,with P < 0.05,indicating statistically significant differences.The correlation coefficient between the lesion range of M and the percentage of CD8+T lymphocytes was 0.399(P < 0.05),and the difference was statistically significant.It was found that the lesion range was negatively correlated with CD3+T cell level,CD4+T lymphocyte level,and CD4+/CD8+ level to a moderate extent,and positively correlated with CD8+T cell level to a moderate extent.Conclusion:1.A higher proportion of TB patients in the cell-phone dependent group had cough and shortness of breath than those in the cell-phone dependent group;2.The range of lesions in the mobile phone-dependent group was more extensive than that in the non-mobile phone-dependent group;3.The levels of nutritional indicators ALB and PA of the patients with mobile phone dependence were lower than that of the patients without mobile phone dependence;4.The inflammatory indexes of CRP and ESR in the mobile phone dependent group were higher than those in the non-mobile phone dependent group.5.The ratios of CD4+T lymphocytes and CD4+ /CD8+ were lower and the levels of CD8+ T lymphocytes were higher in the cell-phone dependent group.It is suggested that mobile phone dependence may be involved in the occurrence and development of pulmonary tuberculosis by affecting the cellular immunity of the body.6.Correlation analysis between MPAI score and cellular immune indicators showed that MPAI score was negatively correlated with CD4+T cells and CD4+/CD8+ ratio to a moderate extent,but not with CD3+T cells and CD8+T cells.The higher the score of cell phone dependence,the more unfavorable to the cellular immune function of the body.7.Correlation analysis of all immune indicators and inflammatory indicatorsshowed that except WBC,all inflammatory indicators were negatively correlated with CD3+T lymphocyte level,CD4+T lymphocyte level and CD4+/CD8+T lymphocyte level to a medium degree,and positively correlated with CD8+T lymphocyte level to a medium degree.8.Correlation analysis between the lesion range and various immune indicators showed that the lesion range was moderately negatively correlated with the levels of CD3+T cells,CD4+T lymphocytes,and CD4+/CD8+,and moderately positively correlated with the levels of CD8+T cells.9.In the process of TB treatment,reducing the use and dependence on mobile phones through active publicity and education may promote the recovery of TB patients. |
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