126例肺结核合并糖尿病临床分析

Clinical analysis of 126 cases of pulmonary tuberculosis with diabetes

目的探讨肺结核合并糖尿病患者的临床特点及其治疗方法。方法对1998年6月-2002年6月在我院住院的126例肺结核合并糖尿病患者回顾性分析。结果肺结核合并糖尿病男女并发比率差异无显著性;以2型糖尿病为主;具有病灶范围广泛,以干酪性病灶为主,多伴有空洞;痰菌阳性率高;治疗有效率低;复治病人较多的临床特点。治疗上强调控制血糖在14mmol以下,不用EMB抗痨,采用3HRZOS(或Annk)/9-12HRO或用结核清(或力克肺疾)、1321Th、氧氟沙星(O)1.5-2年抗痨治疗;前三月可加用胸腺肽。结论肺结核合并糖尿病患者具有一定的临床特点,用3HRZOS(或AmK)/9-12HRO或用结核清(或力克肺疾)、1321Th、氧氟沙星(O)1.5-2年抗痨治疗,同时将血糖降到14mmol以下为较合理的治疗方法。

Objective To explore the clinical features of complications of diabetes in pulmonary tuerculosis patients and to improve the treatment effects. Methods A total of 126 patients suffering from pulmonary tuberculosis with diabetes (between June 1998 and June 2002) were retrospectively analyzed. Results There were no signficant difference in terms of gender distribution. Most pateitns had Type Ⅱ diabetes mellitus. Some specific features might be as follows: the focuses of infection were widely spreading, most common cases were caseous, the cavity often existed, the occurance of relapse was common, and bacteriological ratio was positive. The useful treartment should be given on controlling the blood sugar level (under 14 mmol), using 3HRZOS (or Amk)/9-12HRO or pasiniazide, 1321TH and ofloxacine (O) with 1. 5- 2. 0 years of the treatment. Thymosin can also be used in the first 3 months of the treatment for a better result. Conclusion The patients of pulmonary tuberculosis with diaabetes have special clinical features. A better treatment for those patients may include 3HRZOS (or Amk)/9 - 12HRO or pasiniazide, 1321TH and ofloxacine (O) with the treatment duration of 1. 5- 2. 0 years.