复治涂阳肺结核合并糖尿病20例临床分析

Analysis on 20 cases with retreatment of smear-positive pulmonary tuberculosis complicated by diabetes mellitus

目的探讨复治涂阳肺结核合并糖尿病患者的临床特征,以便早期发现,提高疗效。方法回顾性分析北京市通州区疾病预防控制中心2001—2011年间收治的20例复治涂阳肺结核合并糖尿病患者流行病学特征、X线表现、实验室检查及治疗结果。结果复治涂阳肺结核合并糖尿病患者具有中老年男性比例大,病变范围大,易形成空洞,排菌量大,痰菌阴转慢,耐药发生率高,病灶吸收及治疗效果较差的特征。结论复治涂阳肺结核合并糖尿病患者具有一定的临床特征,治疗应积极调控血糖,及时进行药敏试验及合理的抗结核治疗。

Objective To analyse the clinical characteristics of retreatment smear-positive pulmonary tuberculosis complicated by diabetes mellitus,and to find case earlier and improve treatment effect.Methods The retrospective analysis has been taken on the epidemic features,photographic methods,laboratory test results and treatment effect of 20 cases with pulmonary tuberculosis complicating diabetes treated in Tongzhou District conter for Disease Control and Pneven tion dring 2001 to 2011.Results The case with retreatment positive pulmonary tuberculosis complicated by diabetes mellitus had clinical characteristics as follows:maincy agecl 40 or abooe extensive lesion,easy to form cavity,much mycobacteria in sputum,slow sputum negative conversion high rates of drug resistance,and poor lesion absorption.Conclusions The patients with retreatment smear-positive of pulmonary tuberculosis complicated by diabetes mellitus show specific clinical characteristics. Strict control glycemia,drug-sensitivity test and reasonable antituberculous treatment should be taken into account.