糖尿病合并肺结核60例分析

An analysis of sixty cases of diabetes mellitus complicated with pulmonary tuberculosis

1987年～1997年住院464例肺结核病人中，60例（12．9％）伴有糖尿病，采用回顾性分析方法，分析糖尿病合并肺结核的临床特点及治疗情况。结果表明：≥50岁者45例（75％）。Ⅱ型糖尿病者55例（91．7％）。以咳嗽、咯痰、发热、消瘦、乏力、盗汗、咯血为主要临床表现。83．3％为患糖尿病后伴发肺结核，其起病急骤，病情较重。胸X线片以斑片状影为主31例（51．7％），下肺结核12例（20％）。抗结核治疗6例达3年以上，其中1例达7年。40例（66．7％）需用胰岛素治疗。提示：糖尿病者易伴发肺结核，若能早期诊断，及时合理治疗，预后较好，部分病人抗结核需达3年以上。

To investigate the clinical manifestation and treatment of patients with dlabtes mellitus （DM） complicated with pulmonary tuberculosis(TB)，60 cases of DM with TB were retrospectively recrtuited from 464 patients with pulmonary tuberculosis hoopitalized in the period of 1987 to 1997．The incidence of DM in patients with TB was 12．9%． Among the 60 patients，45 of them(75％)were older than 50 years old．Most of them(55 cases，91.7%) suffered from type 2 DM．The clinical manifestations were cough，expectoration，fever，emaciation，fatigue，night sweating and hemoptysis. The majority(83．3%) initially had DM with acute onset and severe condition．Chest X-ray demonstrated patchy shadows in 31 cases (51．7%)，lower lobe lesions in 12 and cavity formation in 8．Fifteen out of 60 had been misdiagnosed. The anti-tuberculosis chemotherapy lasted for more than 3 years in 6 cases and even for 7 years in one case．Insulin was administered in 40 cases．These indicate that patients with DM are susceptible to TB．Early diagnosis and treatment is crucial for the prognosis．Anti-tuberculosis chemotherapy should exceed 3 years in those cases．