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目的分析肺结核合并2型糖尿病患者的临床特点及其治疗与预后的关系。方法回顾总结和比较2002年1月-2006年6月收治的60例肺结核合并2型糖尿病(研究组)和76例单纯肺结核患者(对照组)的临床资料。两组在性别、年龄及初、复治比例方面比较差异无统计学意义(P>0.05),具有可比性。初治肺结核采用异烟肼和利福平的三药或四药联合;复治肺结核采用丙硫异烟胺和利福喷汀的三药或四药联合,疗程6～15个月。合并糖尿病的患者在饮食控制基础上,给予口服降糖药或皮下注射胰岛素控制血糖。结果研究组发热、盗汗、咯血、合并空洞、痰菌阳性率分别为46.67%,25.00%,43.33%,46.67%,48.33%,明显高于对照组(P<0.05);研究组血糖控制<8.5mmol/L者痰菌阴转率和结核病灶吸收好转率分别为95.45%、90.91%,明显高于血糖≥8.5mmol/L者的50.00%、56.52%(P<0.05)。结论合并2型糖尿病的肺结核患者较单纯肺结核患者病情严重;严格控制血糖水平是肺结核治疗的重要辅助手段。
Objective To analyze the clinical characteristics of patients with pulmonary tuberculosis complicated with type 2 diabetes mellitus and its relationship with prognosis. Methods The clinical data of 60 patients with pulmonary tuberculosis complicated with type 2 diabetes mellitus (study group) and 76 patients with simple pulmonary tuberculosis (control group) were retrospectively reviewed and compared between January 2002 and June 2006. There was no significant difference between the two groups in terms of gender, age, primary and retreatment rates (P> 0.05). Primary treatment of tuberculosis with isoniazid and rifampicin three or four drugs combined; re-treatment of tuberculosis with propylthiouracil and rifapentine three or four drugs, the treatment of 6 to 15 months. Patients with diabetes mellitus on the basis of diet control, given oral hypoglycemic agents or subcutaneous insulin to control blood sugar. Results The positive rates of fever, night sweats, hemoptysis, voids and sputum in the study group were 46.67%, 25.00%, 43.33%, 46.67% and 48.33% respectively, which were significantly higher than those in the control group (P <0.05) mmol / L, the rates of sputum negative conversion rate and tuberculosis absorption rate were 95.45% and 90.91%, respectively, which were significantly higher than 50.00% and 56.52% (P <0.05) of those with blood glucose≥8.5mmol / L. Conclusions Patients with pulmonary tuberculosis complicated with type 2 diabetes are more serious than those with simple pulmonary tuberculosis. Strict control of blood glucose level is an important adjunct to tuberculosis treatment.