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題 名 | 臺灣東部地區漢人與原住民肺結核嚴重度與營養狀態之比較=Comparison of Nutritional Status between Pulmonary Tuberculosis Patients of Chinese and Aborigines in Eastern Area of Taiwan |
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作 者 | 李昭賢; 陳培然; 郭許達; 許碧惠; | 書刊名 | 胸腔醫學 |
卷 期 | 12:4 1997.12[民86.12] |
頁 次 | 頁161-166 |
分類號 | 415.462 |
關鍵詞 | 肺結核; 營養狀態; 漢人; 原住民; Pulmonary tuberculosis; Nutritional status; Chinese; Aborigines; |
語 文 | 中文(Chinese) |
中文摘要 | 肺結核是一種慢性耗損性疾病,活動性肺結核患者經常伴有體重減輕的現象,而營養不良也會影響患者的細胞免疫力,降低對結核菌的抵抗力。本研究旨在比較漢人與原住民肺結核患者營養狀態之差異,並探討營養不良程度與肺結核嚴重度的相關性,以澄清營養不良在臺東區及原住民高肺結核罹患率及死亡率所扮演的角色;本研究取材自馬偕醫院臺東分院肺結核病房,曾於民國八十四年一月至八十五年五月間住院之肺結核病患,經排除胃切除、矽肺症、糖尿病、肝、腎功能異常、癌症或懷孕等影響營養評估之因素或肺結核之危險因子後,篩選從未接受過抗結核藥物治療且經診斷確定為開放性肺結核之患者,共計34例(漢人18例,原住民16例);患者之胸部x光影像之肺結核病灶範圍依國際結核協會的分類標準判定為輕度、中度或重度。營養狀態評估項目包括身體檢查測量身高、體重、中臂環圍、肱三角肌皮下脂肪厚度,血液檢驗檢查全血蛋白質、血清白蛋白、血清鐵結合總容量並換算為血清運鐵蛋白以及淋巴球總數,上述項目參照該病例身高、性別和年齡,以理想值為標準,並代換公式求出理想體重百分比、中臂肌肉環圍百分比、肌甘酸-身高指數百分比、肱三角肌皮下脂肪厚度百分比、身體質量指數,以代表實際測量值偏離理想值的程度。本研究結果顯示漢人與原住民活動性肺結核患者的營養狀態指標均呈現中度營養不良,顯示營養不良確為肺結核之易感因子;至於漢人與原住民兩族群營養狀態與胸部x光嚴重度之比較,除原住民胸部x光異常程度較漢人嚴重及原住民中臂肌肉環圍百分比指數顯然大於漢人之外(p<0.05),其餘各營養指標兩族群皆無有意義之差異,由於肌甘酸-身高指數百分比對於反映身體蛋白質缺乏所致的營養不良實較中臂肌肉環圍百分比客觀且其他營養指標也無法反映此等差別。所以無論是反映蛋白質、熱量儲存或身體免疫力的營養指標兩族群皆無統計學上有意義之差異性存在,此一結果顯示原住民與漢人肺結核患者之營養不良程度並無明顯之差別。原住民胸部x光比漢人偏向較嚴重之程度,其原因則可能與原住民患者較缺乏醫學常識及地處偏遠醫療不普及有關。我們將兩族群胸部x光嚴重度分為輕、中度與重度二組與各營養指標比較亦無統計學上有意義的差別,此一結果顯示胸部x光嚴重度與營養不良程度無正相關性,鑑於本研究所收集的住院病例胸部x光重度者居多,日後將繼續收集更多輕、中度病例以進一步釐清此種非相關性是否亦適用於輕、中度患者。 |
英文摘要 | To study the interrelationship between pulmonary tuberculosis and nutritional status, We selected 34 subjects from 119 hospitalized open pulmonary tuberculosis patients at Taitung branch of Mackay memorial hospital from January 1995 to May 1996. The excluding factors were gastrectomy、diabetesmellitus、silicosis、renaldisease、llver disease、cancer or pregnancy. The 34 subjects in this study were grouped into Chinese group (n-18) and aborigines group (n=16) by the racial factor. Their age range from 16 to 88 years. According to the criteria of National Tuberculosis Association (NTA), the extents of pulmonary lesions were evaluated and classified as minimal, moderate or far advanced. Each subject was assessed by measuring body height, body weight, midarm circumference, triceps skinfold, total protein, serum albumin, total iron-binding capacity, total lymphocyte count. These data are converted to percentage of ideal body weight (IBW%), percentage of mid-arm muscular circumference (MAMC%), percentage of creatinine-height index (CHI%), percentage of triceps skinfold (TSF%), body mass index (BMI) by individual height, age and sex. There is no statistic difference in nutritional indices of two races except the MAMC% is larger in aborigines. Because CHI% is a more objective indicator of somatic protein status than MAMC% index, there's no statistic difference in nutritional status of two races. This study divided pulmonary lesions into minimal-moderate and far-advanced extent. The nutritional indices were compared in two chest radiographic extents by paired t-test, but there was no statistic significance (P>0.05). The result reveals malnutrition is one risk factor of pulmonary tuberculosis. There is no positive correlation between malnutrition and chest radiographic extents. It remains to be explored whether no positive relationship still exists between malnutrition and chest radiographic extent by adding the number of minimal or moderate chest radiographic extent patients. |
本系統中英文摘要資訊取自各篇刊載內容。