Study On The Relationship Between Prognostic Nutritional Index(PNI) And Prognosis Of Patients With Secondary Pulmonary Tuberculosis

Objective: To explore the relationship between prognostic nutritional index(PNI)and the efficacy of anti-tuberculosis treatment in patients with secondary pulmonary tuberculosis.Methods: The clinical data of patients with secondary pulmonary tuberculosis who were treated in the affiliated Hospital of Zunyi Medical University from January 2017 to January 2019 were retrospectively analyzed.204 cases of newly diagnosed secondary pulmonary tuberculosis were screened out of 4438 cases of secondary pulmonary tuberculosis by inclusion and exclusion criteria,and their clinical data are collected,including age,sex,whether smoking,whether with diabetes,lymphocyte count,albumin level,chest computerized tomography signs,sputum tuberculosis test results(including smears and culture)and other information,and the prognostic nutritional index were calculated.Multivariate Logistic regression analysis was used to analyze whether the prognostic nutritional index was a factor affecting the efficacy of anti-tuberculosis treatment at the end of the second month and the sixth month and Receiver Operating Characteristic(ROC)curve was used to evaluate the prognostic value of prognostic nutritional index for the efficacy of anti-tuberculosis treatment at the end of second month and the sixth month in newly treated patients with secondary pulmonary tuberculosis.Results:The results of single factors affecting the curative effect of anti-tuberculosis treatment at the end of the second month showed that the diseased pulmonary lobes(P=0.001),sputum smear(P=0.034),smoking(P=0.011)and prognostic nutritional index(P<0.001)were significantly correlated with the curative effect of anti-tuberculosis,The results of multivariate Logistic regression analysis showed that the prognostic nutritional index [OR=1.099,95%CI(1.044-1.157),P<0.001],the number of diseased lobes[OR=0.752,95%CI(0.595-0.950),P=0.017],smoking[OR=0.407,95%CI(0.195-0.850),P=0.017] were the influencing factors of anti-tuberculosis efficacy of secondary tuberculosis.2.The results of single factor influencing the efficacy of anti-tuberculosis treatment at the end of the sixth month showed that the prognostic nutritional index(P<0.001),number of diseased lobes(P<0.001),smoking(P<0.001)were significantly correlated with the efficacy of anti-tuberculosis.The results of multivariate Logistic regression analysis showed that prognostic nutritional index[OR=1.098,95%CI(1.036-1.164),P=0.002],number of diseased lobes[OR=0.683,95%CI(0.516-0.904),P=0.008],smoking[OR=0.361,95%CI(0.171-0.763),P=0.008] were the influencing factor of the efficacy of anti-tuberculosis treatment for secondary tuberculosis.3.The ROC curve of the prognostic nutritional index at the end of the second month of anti-tuberculosis treatment showed that the area under the ROC curve was0.688;the ROC curve of the prognostic nutritional index at the end of the sixth month of anti-tuberculosis treatment showed that the area under the ROC curve was 0.703.Conclusion:1.PNI,the number of diseased lobes and smoking are all important factors affecting the anti-tuberculosis efficacy of secondary pulmonary tuberculosis.2.PNI has certain predictive value for the anti-tuberculosis efficacy of secondary pulmonary tuberculosis.