1. Department of Clinical Laboratory, Loudi Central Hospital, Hu′nan Province, Loudi 417000, China;
2. Department of Clinical Laboratory, Maternal and Child Health Hospital, Hu′nan Province, Loudi 417000, China
Objective To analyze the changes of liver and kidney function, blood routine and adverse reactions in patients with active pulmonary tuberculosis before and after anti-tuberculosis drug treatment, and to find out the monitoring indicators that can be used for the efficacy of anti-tuberculosis treatment. Methods A total of 55 patients with active pulmonary tuberculosis who received anti-tuberculosis drug treatment in Loudi Central Hospital from January 2019 to January 2020 were selected as case group, and 55 healthy people in the same period were selected as control group.The related clinical data and test results were collected, and the adverse reactions during anti-tuberculosis drug treatment in the case group were recorded. The dynamic changes of blood routine and liver and kidney function before and after treatment in the case group and the control group were detected. Results Before treatment, there were no significant differences in white blood cell count (WBC) and platelet/lymphocyte ratio (PLR) between case group and control group (P>0.05). The red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) in the case group were higher than those in the control group, and the differences were statistically significant (P<0.05). The incidence of liver function damage was the highest in the case group, among which the incidence of alanine aminotransferase (ALT)and/or aspartate aminotransferase (AST) increased was 18.18%, the incidence of bilirubin (TBil) increased was 10.91%, followed by gastrointestinal reaction (14.55%).The incidence of elevated uric acid (UA), allergic reaction, leukopenia and thrombocytopenia were 9.09% ,3.64%, 7.27% and 3.64%, respectively. There were no significant differences in WBC, PLR and TBil before and after treatment in the case group (P>0.05). RDW and NLR were lower after treatment than before treatment, ALT and/or AST and UA were higher than before treatment, and the differences were statistically significant (P<0.05). Conclusion Patients undergoing antituberculosis therapy need regular evaluation of blood routine and liver and kidney function, close attention to adverse reactions, and timely and effective intervention. RDW, NLR and other parameters have important clinical application value in monitoring the therapeutic effect of active pulmonary tuberculosis.
Shi Z,Wu J,Yang Q,et al.Efficacy and safety of milk thistle preventive treatment of anti-tuberculosis drug-induced liver injury:A protocol for systematic review and meta-analysis[J].Medicine (Baltimore),2020,99(52):e23674.
Mer M,Zumla A,Dünser MW.Limiting consumption in tuberculosis:current concepts in anti-tuberculosis treatment in the critically ill patient[J].Intensive Care Med,2018,44(12):2229-2231.
[10]
Dockrell HM,Smith SG.What Have We Learnt about BCG Vaccination in the Last 20 Years?[J]Front Immunol,2017,8:1134.
Bucsan AN,Rout N,Foreman TW,et al.Mucosal-activated invariant T cells do not exhibit significant lung recruitment and proliferation profiles in macaques in response to infection with Mycobacterium tuberculosis CDC1551[J].Tuberculosis (Edinb),2019,116S:S11-S18.
[13]
Teng TS,Ji AL,Ji XY,et al.Neutrophils and Immunity:From Bactericidal Action to Being Conquered[J].J Immunol Res,2017,2017:9671604.
[14]
Scott NR,Swanson RV,Al-Hammadi N,et al.S100A8/A9 regulates CD11b expression and neutrophil recruitment during chronic tuberculosis[J].J Clin Invest,2020,130(6):3098-3112.
[15]
Hilda JN,Das S,Tripathy SP,et al.Role of neutrophils in tuberculosis:A bird′s eye view[J].Innate Immun,2020,26(4):240-247.
[16]
Muefong CN,Sutherland JS.Neutrophils in Tuberculosis-Associated Inflammation and Lung Pathology[J].Front Immunol,2020,11:962.
[17]
Borkute RR,Woelke S,Pei G,et al.Neutrophils in Tuberculosis:Cell Biology,Cellular Networking and Multitasking in Host Defense[J].Int J Mol Sci,2021,22(9):4801.
[18]
Xanthopoulos A,Tryposkiadis K,Dimos A,et al.Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease[J].World J Cardiol,2021,13(9):503-513.
[19]
Rezaeifar P,Nouri-Vaskeh M,Nazemiyeh M,et al.Clinical Utility of Red Cell Distribution Width in Patients with Pleural Effusion[J].Tanaffos,2020,19(4):364-370.
[20]
Karatas M,Oztürk A.The utility of RDW in discrimination of sarcoidosis and tuberculous lymphadenitis diagnosed by ebus[J].Tuberk Toraks,2018,66(2):93-100.