中国西南地区不同部位结核感染儿童的生长发育与贫血情况
Growth and anemia among children with tuberculosis infection at different sites in Southwest China.
作者信息
Gao Zhongmin, Liu Quanbo, Deng Qin, Kong Lin, Liu Yongfang
机构信息
Department of Nutrition, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China.
出版信息
Front Pediatr. 2023 Jun 15;11:1188704. doi: 10.3389/fped.2023.1188704. eCollection 2023.
OBJECTIVES
To explore the effects of tuberculosis (TB) infection at different sites on anthropometric indicators, malnutrition and anemia incidence in children in Southwest China.
METHODS
From January 2012 to December 2021, a total of 368 children aged 1 month to 16 years were enrolled. According to the sites of TB infection, they were divided into three groups: tuberculous meningitis (T group), tuberculous meningitis complicated withpulmonary tuberculosis (TP group), and tuberculous meningitis complicated with pulmonary tuberculosis and abdominal tuberculosis (TPA group). Data on weight, height, nutritional risk, blood biochemical indicators and basic descriptions were collected within 48 h after admission.
RESULTS
The body mass index-for-age score (BAZ), height-for-age score (HAZ), and concentrations of hemoglobin (Hb) and albumin (ALB) decreased in the following order: T group, TP group, and TPA group. The prevalence of malnutrition was the highest in the TPA group (69.5%, 82/118) and 10-to 16-year-old group (72.4%, 63/87). Children aged 0.5-2 years exhibited the highest anemia prevalence of 70.6% (48/68) among the four age groups.The TPA group had the highest incidence of anemia (70.5%, 67/95) compared to T group and TP group.Compared with the treatment group, the abandonment group had a lower BAZ, HAZ and levels of HB and ALB, a higher rate of severe malnutrition, and higher nutritional risk scores. Children who had a low BAZ [odds ratio (OR) = 1.98], nutritional risk (OR = 0.56) and anemia (OR = 1.02) were less likely to obtain treatment with their guardians' support.
CONCLUSIONS
Children with tuberculous meningitis were at risk for growth disorders and anemia, especially when complicated with pulmonary tuberculosis and abdominal tuberculosis. The prevalence of anemia and malnutrition was the highest among patients aged 1 month to 2 years and 10-16 years, respectively. Nutritional status was one of the causes of abandoning treatment.
目的
探讨中国西南地区儿童不同部位结核感染对人体测量指标、营养不良及贫血发生率的影响。
方法
2012年1月至2021年12月，共纳入368例1个月至16岁儿童。根据结核感染部位，将其分为三组：结核性脑膜炎组（T组）、结核性脑膜炎合并肺结核组（TP组）、结核性脑膜炎合并肺结核及腹腔结核组（TPA组）。入院后48小时内收集体重、身高、营养风险、血液生化指标及基本情况描述等数据。
结果
年龄别体质指数（BAZ）、年龄别身高（HAZ）、血红蛋白（Hb）及白蛋白（ALB）浓度依次降低：T组、TP组、TPA组。营养不良患病率在TPA组最高（69.5%，82/118），10至16岁组最高（72.4%，63/87）。在四个年龄组中，0.5至2岁儿童贫血患病率最高，为70.6%（48/68）。TPA组贫血发生率最高（70.5%，67/95），高于T组和TP组。与治疗组相比，放弃治疗组BAZ、HAZ及Hb、ALB水平较低，重度营养不良发生率较高，营养风险评分较高。BAZ低[比值比（OR）=1.98]、有营养风险（OR=0.56）及贫血（OR=1.02）的儿童在监护人支持下接受治疗的可能性较小。
结论
结核性脑膜炎患儿存在生长发育障碍和贫血风险，尤其是合并肺结核及腹腔结核时。贫血和营养不良患病率分别在1个月至2岁和10至16岁患者中最高。营养状况是放弃治疗的原因之一。
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