糖尿病合并肺结核62例临床特点分析

Clinical analysis on pulmonary tuberculosis with diabetes

目的:探讨糖尿病合并肺结核的临床表现及影像学特点,为其早期诊断提供帮助。方法:将收治的2型糖尿病合并肺结核患者62例作为观察组(初治),另随机选择同期单纯肺结核患者60例作为对照组(初治),回顾性对比分析两组临床表现、胸部X线表现、痰抗酸杆菌涂阳率、痰结核杆菌培养阳性率等。结果:观察组咯血、呼吸困难、消瘦、低蛋白血症、痰抗酸杆菌涂阳率、痰结核杆菌培养阳性率及误诊率均高于对照组;观察组病变位于上肺尖后段及下叶背段以外肺野的有20例(32.3%),而对照组仅6例(10.0%),差异有显著统计学意义(P<0.05);观察组病变以团片影为主的有41例(66.1%),而对照组仅8例(13.3%),差异有显著统计学意义(P<0.05);观察组病灶出现空洞的有40例(64.5%),而对照组为18例(30%),差异有统计学意义(P<0.05)。结论:糖尿病合并肺结核患者全身症状及肺部表现均较单纯肺结核患者严重,胸部X线表现偏离单纯典型肺结核,误诊率高;糖尿病患者如胸部影像学提示团片阴影并空洞形成,应警惕肺结核。

Objective To investigate the characteristics of clinical findings and chest X - ray of pulmonary tuberculosis with diabetes. Method From January 2007 to December 2009,62 cases of pulmonary tuberculosis patients with the diabetes were selected as the observation group,60 cases as the control group with the simple pulmonary tuberculosis in the same period. A retrospective analysis of clinical data and chest X - ray were made. Results There were significant differences in fever,dyspnea,hemoptysis,positive sputum smear and cul- ture between the two groups. And there were significant differences in shadow position and shape between the two groups. Conclusion The clinical manifestations of pulmonary tuberculosis with diabetes are severer than those of simple pulmonary tuberculosis. The shadow locating on the non - pulmonary tuberculosis predilection positions of the observation group is more than that of the control group. If the X - ray of diabetes patient shows mass and flake shadow with porosis,we must watch out for pulmonary tuberculosis.