不同糖化血红蛋白控制水平2型糖尿病合并初治菌阳性肺结核患者的临床疗效分析  

Clinical effect analysis of different glycosylated hemoglobin control levels in patients with type 2 diabetic and newly diagnosed smear-positive pulmonary tuberculosis

作　　者：尹平辉 蒋政 黄英 莫运慈 YIN Pinghui;JIANG Zheng;HUANG Ying;MO Yunci(Ninth ward,Hengyang Third People's Hospital,Hengyang,Hunan,421001,China)

机构地区：[1]衡阳市第三人民医院九病区,湖南衡阳421001

出　　处：《当代医学》2023年第4期114-117,共4页Contemporary Medicine

摘　　要：目的探讨不同糖化血红蛋白(HbA1c)控制水平2型糖尿病合并初治菌阳性肺结核患者的临床疗效。方法回顾性分析2019年1月至2020年12月衡阳市第三人民医院收治的100例2型糖尿病合并初治菌阳性肺结核患者的临床资料,均予以降血糖及抗结核方案HRZE治疗。根据治疗2个月后HbA1c控制水平分为糖尿病控制良好组(HbA1c控制水平<7%,n=28)、糖尿病控制中等组(HbA1c控制水平7%~<8%,n=52)、糖尿病控制不良组(HbA1c控制水平≥8%,n=20),比较3组胸部CT病灶吸收率、痰菌阴转率及低血糖发生率。结果3组胸部CT病灶吸收率比较差异有统计学意义(P<0.05);糖尿病控制良好组和糖尿病控制中等组胸部CT病灶吸收率均高于糖尿病控制不良组,差异有统计学意义(P<0.05);糖尿病控制良好组与糖尿病控制中等组胸部CT病灶吸收率比较差异无统计学意义。3组痰菌阴转率比较差异有统计学意义(P<0.05);糖尿病控制良好组和糖尿病控制中等组痰菌阴转率均高于糖尿病控制不良组,差异有统计学意义(P<0.05);糖尿病控制良好组与糖尿病控制中等组痰菌阴转率比较差异无统计学意义。3组低血糖发生率比较差异有统计学意义(P<0.05)。糖尿病控制良好组低血糖发生率为50.0%,高于糖尿病控制中等组和糖尿病控制不良组的11.5%、5.0%,差异有统计学意义(P<0.05);糖尿病控制中等组与糖尿病控制不良组低血糖发生率比较差异无统计学意义。结论规律抗结核、降血糖治疗基础上,HbA1c控制在7%~<8%的2型糖尿病合并初治菌阳肺结核患者疗效较好,可提高病灶吸收率、痰菌阴转率,且低血糖发生率较低。Obiective To explore the clinical efficacy of different glycosylated hemoglobin(HbA1c)control levels in patients with type 2 diabetic and newly diagnosed smear-positive pulmonary tuberculosis.Methods The clinical data of 100 patients with type 2 diabetes mellitus combined with newly diagnosed smear-positive pulmonary tuberculosis admitted to the Hengyang Third People's Hospital from January 2019 to December 2020 were ret-rospectively analyzed,all patients were treated with hypoglycemic and anti-tuberculosis regimen HRZE treatment.The patients were divided into well controlled group(HbA1c control level<7%,n=28),medium controlled group(HbA1c control level 7%-<8%,n=52)and poorly controlled group(HbA1c control level≥8%,n=20)according to the control level of HbA1c after 2 months treatment,the absorption rate of chest CT lesions,sputum negative conversion rate and the incidence of hypoglycemia were compared among the three groups.Results There was significant difference in the absorption rate of chest CT lesions among the three groups(P<0.05);the absorption rate of chest CT lesions in the well controlled group and medium control group were higher than that in the poorly controlled group,the difference was statistically significant(P<0.05);there was no significant difference in the absorption rate of chest CT lesions between well controlled group and medium control group.There was statistical significance in the sputum negative conversion rate among the three groups(P<0.05);and the sputum negative conversion rate in the well controlled group and medium control group were significantly higher than that in the poorly controlled group,the difference was statistically significant(P<0.05);there was no significant difference in sputum negative conversion rate between the well controlled group and the medium controlled group.The incidence of hypoglycemia in the well controlled group was 50.0%,which was higher than 11.5%in the medium controlled group,5.0%in the poorly controlled group,the differences were statistically signif

关 键 词：糖化血红蛋白 2型糖尿病 初治痰菌阳性 肺结核 

分 类 号：R521[医药卫生—内科学] R587.1[医药卫生—临床医学]