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目的 分析老年肺结核患者的血清白蛋白(ALB)、血红蛋白(HGB)等相关营养指标，探讨营养不良与老年肺结核疾病的相关性。方法 检测2016年1月至6月107例老年(均≥60岁)肺结核患者的血清总蛋白(TP),ALB、球蛋白(GLB)、白球蛋白比(A/G)、全血红细胞计数(RBC)、血红蛋白(HGB),淋巴细胞计数、补体3(C3),C4 ,C反应蛋白(CRP)水平，了解所有患者相关指标情况。然后根据痰涂片结核分枝杆菌阳性(涂阳)和阴性(涂阴)，将患者分为涂阳组和涂阴组，比较两组各营养指标和炎症指标的差异。并对全部患者血清ALB水平和淋巴细胞计数的相关性，以及其和CRP水平的相关性，分别进行Paarson相关性分析。结果 107例老年肺结核患者RBC,HGB,淋巴细胞计数、TP,ALB,GLB,A/G等营养指标均降低，以血清ALB降低率最高，达43.93%。涂阳组ALB,HGB,A/G水平明显低于涂阴组，CRP水平明显高于涂阴组，差异均有统计学意义(P均<0.05)。相关性分析结果显示，老年肺结核患者(包括涂阳、涂阴)血清ALB水平与淋巴细胞计数呈正相关(r=0.297,P <0.05);与CRP水平呈负相关(r=-0.600,P<0.01)。结论 老年肺结核患者普遍存在血清ALB降低。ALB,HGB,A/G降低在涂阳患者中更为明显，是疾病进展的高危因素，应积极进行干预。
Objective To analyze the nutritional indexes of serum albumin (ALB) and hemoglobin (HGB) in elderly patients with pulmonary tuberculosis and to explore the correlation between malnutrition and elderly pulmonary tuberculosis. Methods Serum total protein (TP), ALB, globulin (GLB), white blood globulin ratio (A / G), whole blood red blood cell count (RBC), hemoglobin (HGB), lymphocyte count, complement 3 (C3), C4 and C-reactive protein (CRP) levels in all patients. Then according to the sputum smear Mycobacterium tuberculosis positive (smear positive) and negative (smear negative), the patients were divided into smear-positive group and smear-negative group, and the differences between the two groups in nutritional index and inflammatory index were compared. Parson correlation analysis was performed on the correlation between serum ALB level and lymphocyte count in all patients and their correlation with CRP level. Results The nutritional indicators such as RBC, HGB, lymphocyte count, TP, ALB, GLB and A / G were all decreased in 107 elderly patients with pulmonary tuberculosis. The serum ALB level was the highest, reaching 43.93%. The levels of ALB, HGB and A / G in the smear positive group were significantly lower than those in the smear negative group, and the CRP levels in the smear positive group were significantly higher than those in the smear negative group (all P <0.05). Correlation analysis showed that there was a positive correlation between serum ALB level and lymphocyte count in elderly patients with pulmonary tuberculosis (r = 0.297, P <0.05) and negative correlation with CRP level (r = -0.600, P < ; 0.01). Conclusion The prevalence of ALB in elderly patients with pulmonary tuberculosis is low. ALB, HGB, A / G reduction in smear-positive patients is more obvious, is the risk of disease progression, should actively intervene.