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营养指数预测多种/利法素耐药结核病患者的全因死亡率
Shengling Hu1,2,3,4, Jinqiang Guo5, Zhe Chen6
1Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430023, People's Republic of China.
Infection and drug resistance
|August 6, 2024
概括
营养指数,如血红蛋白-专蛋白-淋巴细胞-血小板 (HALP) 评分,预后营养指数 (PNI) 和控制营养状况 (CONUT) 评分,可以预测多药耐药结核病 (MDR/RR-TB) 患者的死亡率. 对于高风险个体,建议进行例行营养不良查.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 营养科学 营养科学
背景情况:
- 多种药物和利芬素耐药结核病 (MDR/RR-TB) 由于死亡率高,对全球健康构成了重大挑战.
- 在MDR/RR-TB患者中确定所有原因死亡率 (ACM) 的可靠预测因素对于有效管理至关重要.
研究的目的:
- 评估营养指数对被诊断患有MDR/RR-TB的患者全因死亡率 (ACM) 的预测能力.
- 确定营养状况是否可以作为该患者群体死亡率的预后标志物.
主要方法:
- 一项回顾性研究涉及524名MDR/RR-TB患者,分为培训和验证队列.
- 分析了营养指数,包括血红蛋白-专蛋白-淋巴细胞-血小板 (HALP) 评分,预后营养指数 (PNI) 和控制营养状况 (CONUT) 评分.
- 使用Kaplan-Meier生存分析,Cox回归和ROC分析来评估生存结果和预测性能.
主要成果:
- 与营养风险较低的组 (LNRGs) 相比,被归类为高营养风险组 (HNRGs) 的患者的整体存活率 (OS) 显着较低.
- 低HALP得分,低PNI和高CONUT得分被确定为ACM的独立风险因素.
- 接收器运行特性 (ROC) 分析显示了ACM的强大预测性能,组合指数达到0.811.11的曲线下的面积 (AUC).
结论:
- 营养指数如HALP得分,PNI和CONUT得分是MDR/RR-TB患者中ACM的有效预测指标.
- 应将常规营养不良查纳入临床实践,以识别有风险的MDR/RR-TB患者.
- 对高风险患者的营养支持可能有助于降低死亡率.
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