肺结核合并糖尿病53例治疗效果分析

Analysis on Treatment Effect among 53 Cases of Pulmonary Tuberculosis with Diabetes

[目的]探讨肺结核合并糖尿病患者的治疗方法和治疗效果。[方法]将1997～2005年济源市疾病预防控制中心结核病防治门诊确诊的所有的肺结核患者1529例患者分为2组，其中53例合并糖尿病者为糖尿病组，其余1476例患者为对照组，2组均给予2HRZE／4H3R3或2H3R2Z3E3／4H3R3方案治疗，比较其治疗效果。[结果]痰菌阴转率，治疗2个月、3个月糖尿病组分别为62．22％、75．56％，对照组分别为g5．80％、92．41％（P〈0．01）；疗程结束时糖尿病组为86．67％，对照组为92．74％（P〉0．05）。症状消失或明显改善时间，糖尿病组为43．00±7．51d，对照组为20．00±5．58d（P〈0．05）；疗程糖尿病组为11．60±2．58个月，对照组为7．20土1．21个月（P〈0．05）。疗程结束时胸片吸收好转率，糖尿病组为84．91％，对照组为87．47％（P〈0．05）。治疗2个月、3个月时，空洞闭合者所占比例糖尿病组分别为11．43%、42．86％，对照组分别为29．79％、64．49％（P〈0．05）；疗程结束时2组分别为94．29％、96．19％（P〉0．05）。[结论]肺结核合并糖尿病患者治疗较单纯肺结核困难，传染期延长，病变吸收缓慢，应积极采取措施治疗。

[Objective]To explore the treatment methods and effects of tuberculogis with diabetes cases. [Methods]All the 1 529 tuberculosis diagnosed patients at Jiyuan center for disease control and prevention TB control clinic were divided into 2 groups,of which 53 cases with diabetes.diabetes group, the remaining 1 476 patients were the control group. Two groups were given 2HRZE/4H3R3 or 2H3R3Z3E3/4H3R3 regimen to compare their therapeutic effect. [Results ] Sputum conversion rates, after treatment of 2 months and 3months, the diabetes group were 62.22 % and 75.56 %. The control group were 85.80% and 92.41%（ P 〈0.01）. At the end of treatment,the diabetes group was 86.67% and the control group was 92.74% （ P 〉0.05）. The time of symptoms disappearance or significant improvement,the diabetes group were 43.00±7.51 days and the control group 20.00±5.58 days（ P 〈0.05）. The average treatment time was 11.60 ±2.58 months in the diabetes group and 7.20±1.21 months in the control group （ P 〈0. 05）At the end of treatment,improvement in chest X-ray absorption rate was 84.91 % in the diabetes group and 87.47% in the control group （ P 〈0. 05）. After treatment of 2 months and 3 months, the hole closing proportion was 11.43 % and 42.86% in the diabetes group,29.79% and 64.49% in the control group （ P 〈0.05）. At the end of treatment,the two groups were 94.29% and 96.10% （ P 〉0.05）. [Conclusion]Because of longer transmission period and lesions slow absorption,treatment of patients with pulmonary tuberculosis with diabetes was more difficult than simple tuberculosis, so active treatment should be adopted.