Kennedy N, Ramsay A, Uiso L, Gutmann J, Ngowi F I, Gillespie S H
Division of Communicable Diseases, Royal Free Hospital School of Medicine, London.
Trans R Soc Trop Med Hyg. 1996 Mar-Apr;90(2):162-6. doi: 10.1016/s0035-9203(96)90123-6.
We assessed nutritional status in 200 adult Tanzanian patients with smear-positive pulmonary tuberculosis before, during, and after 6 months of tuberculosis treatment; 148 patients (74%) were successfully followed for 12 months. Marked nutritional impairment was present on admission: 77% of males and 58% of females had a body mass index (BMI) below 18.5; approximately one-fifth had BMI < 16.0. The length of hospital stay and gender, rather than microbiological response, were the major determinants of weight gain during treatment. Patients infected with human immunodeficiency virus (HIV) gained more weight than uninfected patients. Most patients lost weight after completing treatment and returning home. At 12 months, 32% of male and 19% of female patients considered cured of tuberculosis had BMI < 18.5. It is concluded that patients with tuberculosis from this area of Tanzania frequently have evidence of malnutrition both before and after treatment for tuberculosis. Weight gain during therapy appeared to be an unreliable indicator of overall treatment response. However, the results also demonstrated that nutritional rehabilitation can be successfully achieved even in HIV-positive tuberculosis patients and in patients with a suboptimal response to therapy.
我们对200名涂片阳性的成年坦桑尼亚肺结核患者在结核病治疗的6个月期间及治疗前、后的营养状况进行了评估；148名患者（74%）成功随访了12个月。入院时存在明显的营养损害：77%的男性和58%的女性体重指数（BMI）低于18.5；约五分之一的人体重指数<16.0。住院时间和性别而非微生物学反应是治疗期间体重增加的主要决定因素。感染人类免疫缺陷病毒（HIV）的患者比未感染患者体重增加更多。大多数患者在完成治疗回家后体重减轻。在12个月时，被认为结核病已治愈的男性患者中有32%、女性患者中有19%的体重指数<18.5。得出的结论是，来自坦桑尼亚该地区的肺结核患者在结核病治疗前后经常有营养不良的证据。治疗期间体重增加似乎是总体治疗反应的不可靠指标。然而，结果也表明，即使在HIV阳性的肺结核患者以及对治疗反应欠佳的患者中，营养康复也能够成功实现。
