Abstract: Objective To compare whether there is a significant difference in disease outcomes between anemic and non-anemic patients with pulmonary tuberculosis. Methods A retrospective analysis was conducted on 253 inpatients diagnosed with pulmonary tuberculosis at our hospital from January 1 st, 2023 to December 31 st, 2023. Patients were divided into two groups based on anemia status: anemic group (n=163) and non-anemic group (n=90). Clinical characteristics were analyzed hematological indices、sputum bacterial load and imaging data were compared before and after treatment. Logistic regression analysis was used to clarify the correlation between anemia and sputum bacterial load and pulmonary pathological damage, to further explore the impact of anemia on pulmonary tuberculosis outcomes. Results The anemia rate among pulmonary tuberculosis patients in our hospital exceeds 60%, the main type of anemia is normocytic normochromic anemia. Before treatment, anemic patients with pulmonary tuberculosis showed differences in hematological indices compared to non-anemic patients, including neutrophil percentage (NEUT%)、lymphocyte percentage (LY%)、absolute neutrophil count (NEUT#)、absolute lymphocyte count (LY#)、red blood cell distribution width coefficient of variation (RDW-CV)、aspartate aminotransferase (AST)、total protein (TP)、albumin (ALB), prothrombin time (PT)、prothrombin activity (PA)、thrombin time (TT)、D-dimer (DD), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). After treatment, anemic patients still exhibited differences in LY#、LY%、monocyte percentage (MONO%)、RDW-CV、TP、ALB and ESR, indicating anemia's impact on the hematopoietic system and immune cell function. Anemic patients had poorer treatment efficacy, longer treatment duration, higher rates of pulmonary cavitation and pleural effusion, delayed cavitary closure, slow pleural effusion absorption, and increased pulmonary injury areas. Logistic regression analysis confirmed that anemia was a correlated factor for increased sputum bacterial load and aggravated pulmonary pathological damage. Conclusion Anemia negatively affects treatment outcomes in pulmonary tuberculosis patients, anemia is a risk factor for pulmonary injury. Differences in blood test indicators before and after treatment suggest poor prognosis.

Key words: Pulmonary tuberculosis, Anemia, Outcome, Sputum bacterial load