| Objective:This study aims to investigate the protein nutritional status,sputum test results and clinical symptoms of pulmonary tuberculosis(PTB)patients before treatment and one month after treatment.To analyze the influence of low protein nutritional status on the initial treatment effect of PTB patients.To provide a theoretical basis for improving the low protein nutritional status and adjuvant therapy of PTB patients.Methods:From 2012 to 2020,descriptive epidemiological methods were used to investigate the protein nutritional status of 840 PTB patients diagnosed before intensive treatment in two cities of Shandong Province.Basic information of patients,height,weight,body protein level(including total protein,albumin,hemoglobin)and other data were collected.The food intake(including cereals and potatoes,beans,livestock and poultry meat,fish and shrimp,milk and dairy products,eggs)was collected by the semiquantitative food frequency questionnaire and the three day 24-hour dietary questionnaire,and the protein intake level was calculated.According to the dietary intake lower than the recommended nutrient intake(RNI),body protein level lower than the normal reference value,the patients with low protein nutrition status was determined.The correlation between dietary protein intake and body protein level in PTB patients was analyzed by Logistic regression.On the basis of the above study,399 patients with confirmed PTB were followed up for one month(4 weeks).Medical records,clinical manifestations(including cough,sputum,fever,fatigue,anorexia,and emaciation),and sputum test results were collected.Changes in dietary protein intake and body protein levels before and after antituberculosis treatment were analyzed.Logistic regression was used to analyze the influence of low protein nutrition status on sputum conversion and clinical symptoms improvement in PTB patients before treatment and after one month of treatment.Result:The dietary survey results showed that the average intake of cereals and potatoes,beans,livestock and poultry meat,fish and shrimp,milk and dairy products,eggs in840 PTB patients were 309.00g/d,18.67g/d,50.00g/d,10.00g/d,33.33g/d,and50.00g/d,respectively.Among them,the intake of beans,fish and shrimp,and milk were all lower than the RNI.The average protein intake of PTB patients was 58.72g/d,and 57.1% of the patients’ protein intake was lower than the dietary reference intakes(DRIs).The results showed that the average levels of TP,ALB and HGB in PTB patients were 68.34±8.70g/L,39.76±5.41g/L and 132.01±18.08g/L,respectively.16.2% of the patients had TP levels below normal,17.0% had hypoproteinemia,and 15.6% had significantly reduced HGB levels(anemia).After adjusting for confounding factors,Logistic regression analysis results showed that livestock and poultry meat intake≥93.25g/d,milk intake≥106.67g/d,protein intake≥75.55g/d were significantly correlated with the normal protein level of PTB patients.Analysis of clinical manifestations of 399 PTB patients showed that the incidence of cough,expectoration,fever,fatigue,anorexia and emasculation were 77.9%,67.2%,34.6%,38.8%,40.9% and 25.6%,respectively.Among them,168 patients completed acid-fast bacilli smear test,54.8% of the patients were smear positive.Logistic regression analysis showed that PTB patients with hypoproteinemia or anemia were more likely to show positive sputum bacteria,accompanied by more clinical symptoms.ALB≥42.30g/L and HGB≥144.75g/L were significantly correlated with sputum test results and clinical symptoms.PTB patients were more likely to show negative sputum bacteria with fewer clinical symptoms.After one month of anti-tuberculosis treatment,the incidence of cough,expectoration,fever,fatigue,anorexia and emaciation were 39.1%,28.8%,4.0%,29.3%,17.8% and 11.3%,respectively.31.0% of the patients were smear positive.Logistic regression analysis showed that hypoproteinemia may delay the sputum conversion and clinical symptom improvement in PTB patients.Protein intake≥74.57g/d,TP≥77.80g/L,ALB≥41.90g/L,and HGB≥149.00g/L were significantly correlated with sputum test results and clinical symptoms,which may promote sputum conversion and clinical symptoms improvement in PTB patients.Conclusion:PTB patients have poor protein nutritional status,low dietary protein intake,and high detection rate of hypoproteinemia.Increasing livestock and poultry meat,milk and protein intake may improve protein levels in PTB patients.Poor protein nutritional status may affect the severity of the disease,and delay the sputum conversion and the improvement of clinical symptoms in PTB patients.Therefore,it is suggested that PTB patients should increase the intake of protein-rich food,especially high-quality protein,to improve the nutritional status of protein and promote the recovery of the disease. |
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