108例肺结核合并糖尿病的临床分析  

Clinical analysis of 108 cases of pulmonary tuberculosis complicated with diabetes

作　　者：陈永浩[1] 陈志成[1] 

机构地区：[1]广州市胸科医院内科,广东广州510095

出　　处：《热带医学杂志》2011年第6期670-672,共3页Journal of Tropical Medicine

摘　　要：目的探讨肺结核合并糖尿病患者的临床特点以及血糖控制情况对抗结核疗效的影响。方法回顾性分析临床资料较完整的108例肺结核合并糖尿病患者以及30例单纯肺结核患者的临床资料,以抗结核治疗前后结核病灶范围、晨痰结核菌以及空洞的变化为评价指标,分析肺结核合并糖尿病患者,糖尿病病情的控制与肺结核临床转归的关系。结果在血糖控制理想的患者中(I组),结核病灶吸收好转率、肺结核痰菌阴转率以及空洞缩小率或关闭率分别为94.3%、100%和90%;在血糖控制尚可的患者中(Ⅱ组),结核病灶吸收好转率、肺结核痰菌阴转率及空洞缩小率或关闭率分别为85.4%、92.3%和83.3%;在血糖控制差的患者中(Ⅲ组),结核病灶吸收好转率、肺结核痰菌阴转率及空洞缩小率或关闭率分别为44%、73.3%和42.9%;在对照组患者中(Ⅳ组),结核病灶吸收好转率、肺结核痰菌阴转率及空洞缩小率或关闭率分别为96.7%、100%和100%。经χ2检验,I、Ⅱ、Ⅳ组间差异均无统计学意义(P>0.05)。而I、Ⅱ、Ⅳ组分别和Ⅲ组比较,结核病灶吸收好转率与空洞缩小率或关闭率差异有统计学意义(P<0.01)。结论糖尿病对肺结核抗结核治疗效果有负面影响,良好的血糖控制可能改善抗结核治疗的疗效。Objective To study the clinical characteristics of pulmonary tuberculosis patients complicated with diabetes and the interaction between pulmonary tuberculosis and diabetes. Methods A retrospective analysis was done,including 108 cases of pulmonary tuberculosis complicated by diabetes patients and 30 cases of pulmonary tuberculosis from May 2003 to May 2010 treated in our hospital. Evaluate the change of lesion scope, positive rate of morning sputum TB, and the change of TB cavity. Results Among the cases of ideal blood glucose control（group I ）, the rate of chest X ray resolution was 94.3%, the sputum bacteriological conversion rate was 100% and the rate of cavity close and absorption was 90%. Among the cases of general blood glucose control（group Ⅱ ）, the rates are 85.4%, 92.3% and 83.3%, respectively. Among the cases of poor blood glucose control（group Ⅲ ）, the rates are 44%, 73.3% and 42.9%, respectively. Among the cases of the control group（group IV ）, the rates are 96.7%, 100% and 100%, respectively. There was no significant difference among the group I, Ⅱ , and IV （P〉 0.05）. However, the difference between group Ⅲ and group I , Ⅱ , IV was significant （P〈0.01）. Conclusion Diabetes seems to have a negative effect on the outcome of pulmonary tuberculosis treatment.Well-controlled blood sugar level may improve the outcome of TB treatment.

关 键 词：肺结核 糖尿病 合并症 

分 类 号：R587.1[医药卫生—内分泌]