二甲双胍降糖治疗2型糖尿病合并肺结核的临床特点  

The clinical characteristics of type 2 diabetes complicated with pulmonary tuberculosis during treatment with metformin

作　　者：汪敏[1] 邝浩斌[1] 袁园[1] 冯治宇[1] 蔡晓婷 张宏[1] 吴迪 陈泽莹 黄显林 谭守勇[1] WANG Min;KUANG Haobin;YUAN Yuan;FENG Zhiyu;CAI Xiaoting;ZHANG Hong;WU Di;CHEN Zeying;HUANG Xianlin;TAN Shouyong(State Key Laboratory of Respiratory Disease,Department of Internal Medicine-Tuberculosis,Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]呼吸疾病国家重点实验室,广州市胸科医院结核内科,广州510095 [2]广州市结核病防治所第二分所,广州510320

出　　处：《实用医学杂志》2022年第16期2061-2065,共5页The Journal of Practical Medicine

基　　金：广州市高水平临床重点专科和培育专科建设项目(编号:穗卫函【2019】1555号);广州市科技计划项目(编号:155700012)。

摘　　要：目的探讨二甲双胍(MET)治疗的2型糖尿病(T2DM)患者在合并肺结核时(PTB)的临床特点,为临床治疗策略提供参考。方法收集2013年1月至2018年1月首次在本院住院治疗的T2DM合并初治菌阳PTB患者临床资料。以T2DM患者在首次确诊PTB前3个月以上连续使用MET降糖治疗的为观察组(MET组)206例,以同期在首次确诊PTB前3个月未使用MET治疗的为对照组(N-MET组)749例。结果MET组和N-MET组HbA1c达标率均较低(P=0.703)。两组患者继发感染发生率差异无统计学意义(P=0.703),MET组患者中性粒细胞/淋巴细胞比值(NLR)、肺部病灶广泛程度及空洞发生均较N-MET组低,差异有统计学意义(P=0.021、0.045、0.039)。在HbA1c<7%患者合并肺部空洞发生较少(P<0.001),MET组病灶范围广泛程度较少(P=0.042)。结论MET治疗T2DM患者合并PTB时,NLR水平较低,病灶范围及空洞发生较少。HbA1c<7%的患者并发肺结核时病灶较少。Objective To investigate the clinical characteristics of the pulmonary tuberculosis(PTB)with type 2 diabetes(T2DM)during treatment with metformin(MET)so as to provide reference for clinical treatment strategies.Methods The clinical data of 955 T2DM accompanied by primary PTB from January 2013 to January2018 in our hospital were retrospectively analyzed.Of them,206 patients who had received the therapy with MET for more than three months before primary diagnosis with PTB were assigned into the observation group(MET group)and the rest 749 who had not received the therapy with MET for more than three months before primary diagnosis with PTB at the same period into the control group(NON-MET group).Results There were no statistical differences in the standard level of HbA1c<7%(P=0.703)between both the groups,and so it was with the secondary infection(P=0.703).However,the NLR level,lung lesion range and rate of cavity occurrence in the MET group were all significantly lower or smaller than those in the non-MET group(P=0.021,P=0.045 and P=0.039,respectively).The rate of cavity occurrence among the patients with HbA1c<7%was lower(P<0.001)and the lung lesion range in the MET group was smaller(P=0.042).Conclusion T2DM patients with PTB treated with MET have a lower level of NLR,smaller range of lung lesions and lower rate of cavity occurrence.For those patients with HbA1c<7%,the range of lung lesions is smaller.

关 键 词：二甲双胍 2型糖尿病 肺结核 感染 中性粒细胞/淋巴细胞比值 

分 类 号：R521.5[医药卫生—内科学]