Hachisu Yoshimasa, Murata Keisuke, Takei Kousuke, Tsuchiya Takuma, Tsurumaki Hiroaki, Koga Yasuhiko, Horie Takeo, Takise Atsushi, Hisada Takeshi
Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Japan.
Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.
J Thorac Dis. 2020 Jun;12(6):3101-3109. doi: 10.21037/jtd-20-803.
Although the association between nontuberculous mycobacterial lung disease (NTM-LD) and malnutrition is known, there are a few reports on the association between the nutritional score and death in patients with NTM-LD. This study investigated the association between the nutrition data at the time of NTM-LD diagnosis and death.
A retrospective study was conducted for patients with NTM-LD who visited the Maebashi Red Cross Hospital from January 2014 to December 2018. The patients were divided into the survival and death groups and analyzed statistically.
The diagnostic criteria for NTM-LD were met by 150 patients. The median age was 70 years (range, 20-94 years). There were 51 (34.0%) men and 99 (66.0%) women. In the death group, the body mass index was significantly low, and there were significantly more patients with asthma. Further, computed tomography at the first visit revealed significantly fewer cases of the nodular bronchiectasis type. In the hematologic examination at the time of NTM-LD diagnosis, the white blood cell, neutrophil, and platelet counts and C-reactive protein and serum calcium levels were significantly higher in the death group, while the serum albumin level was significantly lower. In the death group, the prognostic nutritional index (PNI), calculated from the hematologic findings, was significantly lower, while the Glasgow Prognostic Score (GPS) was significantly higher. A logistic regression analysis was performed on items with significant differences, and the PNI and platelet count were independent factors predicting death.
PNI might be effective as a prognostic factor for NTM-LD.
虽然非结核分枝杆菌肺病（NTM-LD）与营养不良之间的关联已为人所知，但关于NTM-LD患者营养评分与死亡之间关联的报道较少。本研究调查了NTM-LD诊断时的营养数据与死亡之间的关联。
对2014年1月至2018年12月期间就诊于前桥红十字医院的NTM-LD患者进行回顾性研究。将患者分为生存组和死亡组并进行统计学分析。
150例患者符合NTM-LD诊断标准。中位年龄为70岁（范围20 - 94岁）。男性51例（34.0%），女性99例（66.0%）。在死亡组中，体重指数显著较低，哮喘患者明显更多。此外，初次就诊时的计算机断层扫描显示结节性支气管扩张型病例明显较少。在NTM-LD诊断时的血液学检查中，死亡组的白细胞、中性粒细胞、血小板计数以及C反应蛋白和血清钙水平显著更高，而血清白蛋白水平显著更低。在死亡组中，根据血液学检查结果计算出的预后营养指数（PNI）显著更低，而格拉斯哥预后评分（GPS）显著更高。对有显著差异的项目进行逻辑回归分析，PNI和血小板计数是预测死亡的独立因素。
PNI可能作为NTM-LD的一个预后因素有效。
