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肺结核相关贫血的患病率、特征及预测因素

Prevalence, characteristics, and predictors of tuberculosis associated anemia.

作者信息

Mukherjee Anirudh, Kaeley Nidhi, Dhar Minakshi, Kumar Subodh, Bhushan Bharat

机构信息

Senior Resident General Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

出版信息

J Family Med Prim Care. 2019 Jul;8(7):2445-2449. doi: 10.4103/jfmpc.jfmpc_311_19.

Abstract

UNLABELLED

Tuberculosis is an infectious disease caused by mycobacterium tuberculosis. It is one of the deadliest disease and a major burden on the healthcare system in India. India, a second most populous country in the world, has a very high global annual incidence of tuberculosis. Multiple hematological changes have been reported in patients with tuberculosis such as iron deficiency anemia, folate deficiency, and sideroblastic anemia.

AIMS AND OBJECTIVES

The present study was planned to find the prevalence and characteristics of anemia in the new cases of pulmonary tuberculosis. The secondary objective was to assess the predictors of anemia in new cases of pulmonary tuberculosis.

METHODS

The retrospective study was carried out at a tertiary care hospital of Uttarakhand and included all the new cases of tuberculosis aged more than 18 years attending medicine outpatient and inpatient departments over a period of 1 year. Detailed demographic, clinical, and biochemical data were obtained from the hospital record section and tabulated.

RESULTS

Most patients with tuberculosis and anemia were more than 50 years of age. Clearly, males outnumbered females. Approximately, 80% patients were illiterates. A majority (71, 39.2%) of the patients had BMI within the range of 18.5 to 24.9 kg/m. The most common symptoms of tubercular patients with and without anemia were cough, fever, breathlessness, and hemoptysis. However, pallor was the most common sign. Clearly, hematological indices were lower in patients with anemia. In total, 112 (60%) patients had mild anemia and 103 (56.9%) patients had normocytic normochromic anemia. Significant association was found between Body Mass Index (BMI) and anemia in patients with pulmonary tuberculosis. Similarly, severity of anemia co-related significantly with BMI of patients with pulmonary tuberculosis. BMI showed a significant correlation with hemoglobin, packed cell volume, mean corpuscular cell volume, and red cell distribution width (RDW). In addition, age showed a significant correlation with hemoglobin and RDW.

CONCLUSION

Normocytic normochromic anemia is a common hematological abnormality in patients with pulmonary tuberculosis. Thus, it warrants frequent screening for anemia in all the cases of pulmonary tuberculosis to improve morbidity and mortality in these patients.

摘要

未标注

结核病是由结核分枝杆菌引起的一种传染病。它是最致命的疾病之一,也是印度医疗系统的一项主要负担。印度是世界上人口第二多的国家,全球结核病年发病率非常高。结核病患者已报告有多种血液学变化,如缺铁性贫血、叶酸缺乏和铁粒幼细胞贫血。

目的

本研究旨在找出新发肺结核病例中贫血的患病率及特征。次要目的是评估新发肺结核病例中贫血的预测因素。

方法

这项回顾性研究在北阿坎德邦的一家三级护理医院进行,纳入了在1年期间到内科门诊和住院部就诊的所有年龄超过18岁的新肺结核病例。从医院记录科室获取详细的人口统计学、临床和生化数据并制成表格。

结果

大多数患有结核病和贫血的患者年龄超过50岁。显然,男性人数多于女性。大约80%的患者是文盲。大多数(71例,39.2%)患者的体重指数(BMI)在18.5至24.9kg/m范围内。有贫血和无贫血的结核病患者最常见的症状是咳嗽、发热、呼吸急促和咯血。然而,面色苍白是最常见的体征。显然,贫血患者的血液学指标较低。总共有112例(60%)患者患有轻度贫血,103例(56.9%)患者患有正细胞正色素性贫血。在肺结核患者中,发现体重指数(BMI)与贫血之间存在显著关联。同样,贫血的严重程度与肺结核患者的BMI显著相关。BMI与血红蛋白、血细胞比容、平均红细胞体积和红细胞分布宽度(RDW)显著相关。此外,年龄与血红蛋白和RDW显著相关。

结论

正细胞正色素性贫血是肺结核患者常见的血液学异常。因此,有必要对所有肺结核病例进行贫血的频繁筛查,以改善这些患者的发病率和死亡率。

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