2型糖尿病合并肺结核的临床研究

Clinical Observation of Type 2 Diabetes Complicated with Pulmonary Tuberculosis

目的探讨2型糖尿病合并肺结核的临床特征。方法对我院2型糖尿病合并初治肺结核66例患者的临床资料进行分析,并动态评价血糖、肺结核病灶及痰菌培养结果的演变情况。结果痰菌阳性者57例(86.5%),继发性肺结核50例(75.8%),慢性纤维空洞型11例(16.7%),粟粒型肺结核3例(4.5%),胸膜结核2例(3.0%),病变广泛者61例(91.9%),有空洞者47例(70.6%);66例中血糖控制良好者有23例(34.8%),血糖控制一般者26例(39.4%),血糖控制差者17例(25.8%),单纯肺结核组疗效(病灶吸收率、空洞闭合率、痰菌阴转率)高于血糖良好组(P<0.05);血糖控制良好组和血糖控制一般组高于血糖控制差组(P<0.05);总疗程1年组空洞闭合率及痰菌阴转率高于总疗程9个月组(P<0.05)。结论控制血糖是治疗糖尿病合并肺结核的关键,长程抗结核治疗效果更佳。

Objective To explore the clinical characteristics of Type 2 Diabetes complicated with pulmonary tuberculosis. Methods Clinical data of 66 Type 2 diabetes patients complicated with pulmonary tuberculosis were analyzed. The measures of changes of blood glucose and tuberculosis focus and tubercle bacilluses in sputum were evaluated. Result8 Sputum positive results on 57 patients （86.5%）,50 patients with secondary pulmonary tuberculosis（75.8%）,chronic type hollow fibers in 11 cases（16.7%）, 3 cases of miliary tuberculosis（4.5%）, pleural tuberculosis two cases （3.0 %）, extensive lesions 61 cases（91.9%）,empty were 47 cases（70.6%）, of 64 cases of blood glucose control as well, there were 23 cases（34.8%）, general control in 26 pafients（39.4%）,glucose poor control of 17 cases （25.8%）, simple group of tuberculosis （lesions absorption rate, cavity closure rate, sputum conversion rates）than good blood glucose（P〈0.05）; good control of blood glucose and control group general group in poor control group（P〈0.05） in the course of a closed group empty sputum conversion rate and the total treatment was higher than that of 9-month group（P〈0.05）. Conclusion Control of blood glucose level is the key in treatment of Type 2 diabetes patients complicated with pulmonary tuberculosis. A long-term treatment period is preferred to a short-term period.