初治菌阳肺结核合并糖尿病67例不同降糖疗法临床分析  

CLINICAL ANALYSIS OF EFFECT OF DIFFERENT TREATMENT METHODS FOR LOWERING BLOOD SUGAR IN 67 CASES WITH SMEAR-POSITIVE PULMONARY TUBERCULOSIS COMPLICATED WITH DIABETES MELLITUS

作　　者：岳冀[1] 李熙[1] 李曦[1] 周小飞[1] 何钟宓[1] 兰华[1] 田明[1] 雷蓉[1] 

机构地区：[1]成都市结核病防治院,成都610000

出　　处：《现代预防医学》2009年第8期1570-1571,共2页Modern Preventive Medicine

摘　　要：[目的]分析初治菌阳肺结核合并糖尿病患者不同降糖疗法与抗结核疗效的关系。[方法]分析67例初治菌阳肺结核合并糖尿病患者的临床资料。[结果]强化期口服降糖组和胰岛素降糖组痰菌阴转率3月末分别为28.1%、54.3%,18个月末为43.8%、74.3%。两组患者痰菌阴转率在3月末、18月末有统计学差异(P﹤0.05)。3月末口服降糖组与胰岛素降糖组X线胸片病灶吸收好转率为21.9%和45.7%,空洞闭合率分别为4.8%和33.3%。18个月末口服降糖组与胰岛素降糖组X线胸片病灶吸收好转率为40.6%和71.4%,空洞闭合率分别为14.3%和45.8%。3月末、18个月末两组患者的X线胸片病灶吸收好转率和空洞闭合率比较差异均有统计学意义(P﹤0.05)。两组患者的疗程结束时临床痊愈率分别为40.6%和71.4%,两者比较差异有统计学意义(P﹤0.05)。[结论]初治菌阳肺结核合并糖尿病的患者使用胰岛素降糖治疗,可以取得更显著的抗结核疗效。[Objective] To investigate the relationship between therapeutic effects of anti-tuberculosis and glucose-lowering methods among patients with smear-positive pulmonary tuberculosis complicated with diabetes mellitus. [Methods] Clinical data of 67 cases with smear-positive pulmonary tuberculosis complicated with diabetes mellitus were collected. [Results] The negative conversion rates of tubercle bacillus in sputum in oral hypoglycemic drugs group and insulin group after intensive treatment for three months were 28.1% and 54.3%, respectively （P﹤0.05）, and after treatment for 18 months, the rates were 43.8% and 74.3%, respectively. There were significant difference between the negative conversion rates of the two groups at the time of 3 months and 18 months. The improving rates of chest X-ray in the two groups were 21.9% and 45.7%, respectively （P ﹤0.05）; The cavity closure rates of the two groups were 4.8% and 33.3% （P﹤0.05）, respectively. After 18 months treatments, the sputum conversion rates in oral hypoglycemic drugs group and insulin group were 28.1% and 54.3% , respectively （P﹤0.05）; The improving rates of chest X-ray in the two groups were 40.6% and 71.4%, respectively （P﹤0.05）; and the cavity closure rates in the two groups were 14.3% and 45.8% （P﹤0.05）. In the end of treatments, the recovery rates in oral hypoglycemic drugs group and insulin group were 40.6% and 71.4%, respectively （P﹤0.05）. [Conclusion] Applying insulin to patients with smear-positive pulmonary tuberculosis complicated with diabetes mellitus could achieve better therapeutic effects than using anti-tuberculosis.

关 键 词：结核 肺 糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R521[医药卫生—内科学]