糖尿病并发肺结核85例临床分析  

CLINICAL ANALYSIS ON 85 CASES OF DIABETES COMBINED WITH PULMONARY TUBERCULOSIS

作　　者：姚公元[1] 张胜男[1] 潘建清[1] 苏建军[1] 何红[1] 

机构地区：[1]深圳市福田区慢性病防治院,深圳518048

出　　处：《现代预防医学》2007年第12期2370-2372,2375,共4页Modern Preventive Medicine

摘　　要：[目的]探讨糖尿病合并肺结核的临床特征,使患者能得到早期诊断、合理治疗,提高治愈率。[方法]对5年来收治的85例糖尿病合并肺结核(简称试验组)患者,随机抽87例单纯性肺结核(简称对照组)患者,对其临床症状、胸部X线表现、实验室检查及抗痨疗效进行回顾性对比分析。[结果]试验组急性或亚急性起病61.17%,咳嗽咯痰88.23%,咯血63.52%,盗汗62.35%,与对照组比较P﹤0.05;胸部X线病变类型:试验组大片浸润或干酪性肺炎为主;病变部位:以下肺野和上下肺野病变为主;痰菌抗酸杆菌:试验组阳性69.41%,两组比较P﹤0.05。疗效:试验组:痊愈39例(45.88%)、好转35例(41.17%)、无效11例(12.94%),总有效率87.05%,两组比较P﹤0.05。[结论]①糖尿病合并肺结核临床上大多急性或亚急性起病,且病变性质大多为大片状阴影,病变部位以下肺野、上下肺野为主;②疗效观察指标中,痰结核菌转阴与肺部病变吸收均与血糖控制有关,控制血糖是关键,疗程宜适当延长。[Objective] To probe into the clinical characteristics of diabetes combined with pulmonary tuberculosis, in order to enable patients to obtain earl.v diagnosis and reasonable treatment and improve the cure rate. [Methods] 85 cases of diabetes combined with puhnonary tuberculosis who were admitted into the hospital for treatment over the past 5 years and 87 cases of puhnonary tuberculosis were selected randomly as the experimental group and the control group. The clinical symptoms, X-ray appearance of chest, laboratory examination and anti-phthisis curative effect of patients in the two groups were analyzed retrospectively. [ Results] In experimental group, the incidence of acute or subacute onset was 61.17G, rate of tussis from sputun was 88.23%, rate of emptysis was 63.52%, rate of night sweat was 62.35%, which were all significantly diffierent from those of control group （P 〈 0.05） ; types of pathological changes in chest radiograph were mass soakage or caseous pneumonia; sections of pathological changes were in the lower lung field and the upper and lower lung fields; the positive rate of acid-fast bacilli in sputum was 69.41%, which was much higher than control group （P 〈 0.05） ; and there were 39 rccmery cases （45.88%）, 35 improvement cases （41.17%） and 11 ineffective cases （12.94%） in experimenttd group, the total efficiency rate was 87.05%, which was obviously different form that of control group （P 〈 0.05） . [ Conclusions] ① Most clinieal cases of diabetes combined with pulmonary tubereulosis arc on acute or sub-acute onset, and the imaging feature of most pathological changes was massive patchy shadow, the sections of pathological changes focus on the lower lung field and the apper and lower lung fields. ② In the indexes observed for curative effect, both negative-conxersion of tubercle bacillus in sputum and absorption of pathological changes in lungs are related to the control of blood sugar. It is critical to control blood sugar, and the period of treatment shouht be

关 键 词：糖尿病 肺结核 临床分析 

分 类 号：R587.1[医药卫生—内分泌] R521[医药卫生—内科学]