[A nutritional and immunological investigation of patients with tuberculosis]

In recent years, the rate of decrease of the number of new patients with tuberculosis has slowed down. The aging of the Japanese population partially accounts for the increase in the number of patients with tuberculosis. The disease is often transmitted from these aged patients to those who were uninfected. Since it is well-known that a poor nutritional condition lowers the immunological resistance to tuberculosis, we used Onodera's PNI (Prognostic Nutritional Index; 10 x serum albumin concentration + 0.005 x peripheral lymphocyte count) as a parameter to check the nutritional condition and immunological deficiency in patients suffering from tuberculosis. We examined a total of 451 patients with tuberculosis who were admitted to our hospital from 1987 to 1991. The PNI value decreased with age and was low in patients with extensive lesions on chest X-ray as well as in those with complications, PNI was also low in patients showing negative tuberculin skin reaction, and increased with the intensification of the positive reaction. In patients showing negative conversion of bacilli during treatment, PNI value on admission increased significantly immediately before discharge. Patients with percent ideal body weight (IBW, calculated by the Broca's method modified by Katsura) on admission less than 90% accounted for 48.6% of all patients. There was a positive correlation between PNI and an obesity index (P < 0.01, r = 0.24). After admission, in patients showing negative conversion of bacilli, there was a positive correlation between the increase in PNI and the gain of body weight (P < 0.01, r = 0.30).(ABSTRACT TRUNCATED AT 250 WORDS)