老年2型糖尿病合并肺结核251例临床特点

CLINICAL CHARACTERISTICS OF 251 CASES OF ELDERLY TYPE 2 DIABETICS COMPLICATED WITH PULMONARY TUBERCULOSIS

目的探讨老年2型糖尿病合并肺结核的临床特点。方法对251例年龄≥60岁糖尿病合并肺结核的病人进行临床资料分析。结果1、两病伴发女性(141例56.2%)明显多于男性(110例43.8%),临床症状不典型,起病多缓慢(243例96.8%);2、结核病灶的性质以干酪及干酪渗出为主(228例90.8%),胸部X线片表现以片状影为主(235例93.6%),侵犯两肺野以上者亦不少见,肺部病变较重,但临床症状不严重,可出现粟粒性肺结核(4例)及支气管淋巴结结核(2例);3、痰菌阳性率高,本组病例高达54.2%;4、120例痰菌由阳转阴者,空腹血糖由8.92±0.86mmol/L下降到7.01±0.26mmol/L,血糖的下降在统计学上具有非常显著性的差异(P＜0.001),说明结核病的控制与糖尿病的积极治疗密切相关。结论老年糖尿病合并肺结核具有一定的临床特征。及时两病兼治,预后良好。

Study on the clinical characteristics of type 2 diabetes of elderly complicated with pulmonary tuberculosis. Methods Clinical analysis of 251 diabetic cases, age ≥ 60, with pulmonary tuberculosis was performed. Results ①The incidence of diabetics with pulmonary tuberculosis in female (56.2 %) is higher than in male (43.8%) .clinical symptoms are atypical, the onset is insidious.② The character of pulmonary focus was mainly the form of caseation or caseous effusion (90.8%). Chest X-ray was showed lamelliform (93.6%), some over two lobes. However it appeared so seriously, clinical symptoms were not severe. Pulmonary miliaris tuberculosis (4 cases) or bronchial lymphonode tuberculosis (2 cases) were sometimes diagnosed.③ Sputum positive with tuberculosis was high (54.2%) in the group.④ It was showed a close relation between the treatment of pulmonary tuberculosis and diabetes. In this group (120 cases) fasting glucose was decreased from 8.92 ± 0.86 mmol/ L to 7.01 ± 0.26 mmol/L and sputum positive to negative. The significant statistic difference was demonstrated ( P < 0.001). Conclusions There was certainly clinical characteristic in elderly type 2 diabetics complicated with pulmonary tuberculosis. The best prognosis would be occurred, while treated with two diseases.