Saha K, Rao K N
Department of Immunology, Vallabhbhai Patel Chest Institute, University of Delhi, India.
Eur J Clin Nutr. 1989 Feb;43(2):117-28.
We have compared the nutritional status of patients with lepromatous leprosy coinfected with pulmonary tuberculosis (18 cases) with that of lepromatous leprosy (239 cases) and of pulmonary tuberculosis (21 cases) and with that of healthy controls. There was a severe weight loss and reduction of skinfold thickness in the patients with pulmonary tuberculosis as well as in lepromatous patients with associated pulmonary tuberculosis, but not in patients with lepromatous leprosy. Levels in sera of diet-dependent proteins, such as albumin, prealbumin and retinol binding protein, were significantly decreased in all three groups of patients; on the other hand, levels of the diet-independent proteins, such as the immunoglobulins, were raised in all the groups, particularly in the pulmonary tuberculosis patients as compared with healthy controls. Serum transferrin levels were decreased only in the tuberculosis patients with or without lepromatous leprosy, but not in patients with leprosy alone. While haemoglobin levels decreased in all patient groups, serum iron concentrations were reduced most in lepromatous patients concomitantly infected with pulmonary tuberculosis. Serum ferritin levels increased in the sera of pulmonary tuberculosis and lepromatous leprosy patients, but was severely reduced in lepromatous patients with associated pulmonary tuberculosis. Mean serum zinc and calcium levels were decreased in all three groups of patients, while the serum copper concentration was increased in all of them compared with healthy controls. Also, inorganic phosphorus was elevated in tuberculosis and lepromatous patients coinfected with pulmonary tuberculosis, but not in lepromatous patients. Serum calcitonin levels were increased in all patient groups indicating an inverse correlation between serum calcium and calcitonin levels. This is the first comparative report describing the status of macro- and micronutrients in two most important mycobacterial diseases of the third world countries.
我们比较了合并肺结核的瘤型麻风患者（18例）与瘤型麻风患者（239例）、肺结核患者（21例）以及健康对照者的营养状况。肺结核患者以及合并肺结核的瘤型麻风患者均出现严重体重减轻和皮褶厚度减小，但单纯瘤型麻风患者未出现此情况。三组患者血清中依赖饮食的蛋白质水平，如白蛋白、前白蛋白和视黄醇结合蛋白，均显著降低；另一方面，三组患者中不依赖饮食的蛋白质水平，如免疫球蛋白，均升高，尤其是肺结核患者与健康对照者相比升高更为明显。血清转铁蛋白水平仅在合并或未合并瘤型麻风的肺结核患者中降低，而单纯瘤型麻风患者未降低。虽然所有患者组的血红蛋白水平均下降，但合并肺结核的瘤型麻风患者血清铁浓度降低最为明显。肺结核和瘤型麻风患者血清铁蛋白水平升高，但合并肺结核的瘤型麻风患者血清铁蛋白水平严重降低。三组患者血清锌和钙的平均水平均降低，而与健康对照者相比，三组患者血清铜浓度均升高。此外，合并肺结核的肺结核和瘤型麻风患者无机磷升高，而单纯瘤型麻风患者未升高。所有患者组血清降钙素水平均升高，表明血清钙与降钙素水平呈负相关。这是首篇比较描述第三世界国家两种最重要分枝杆菌病中大量和微量营养素状况的报告。
