糖尿病合并肺结核72例临床分析

Clinical analysis of 72 cases of diabetes with pulmonary tuberculosis

目的提高对糖尿病合并肺结核的认识。方法西安市结核病胸部肿瘤医院住院的72例糖尿病肺结核患者的资料进行整理分析。结果 72例糖尿病肺结核患者中,45岁以下者40例(40/72),影像学以干酪样病变为主者40例(40/72),空洞形成者48例(48/72),菌阳者60例(60/72),空腹血糖控制在8.0 mmol/L以下者60例(60/72),治疗1月病灶吸收好转者52例,痰菌1月阴转者34例,2月阴转者5例,3月阴转者2例,12例空腹血糖>8 mmol/L,其中5例血糖>11.1 mmol/L,随诊痰菌3月阴转者2例,3～6月痰菌阴转者3例。结论糖尿病合并肺结核的人群趋于年轻化,影像学表现常累及多个肺段,空洞形成多见,传染性强。有效地控制血糖,将空腹血糖控制在8 mmol/L以下时,有利于肺结核的治疗。

Objective To improve the understanding of diabetes with pulmonary tuberculosis. Methods The data of 72 patients of diabetes with pulmonary tuberculosis from tuberculosis and thoracic tumor hospital from 2009 to 2011 were analyzed. Results In 72 eases of diabetes with pulmonary tuberculosis, 40 cases （40/72） were inferior to 45 years, caseous lesions in 40 patiens （40/72） , cavitation in 48 cases （48/72） , 60 cases （60/72） were smear positive, and plasma glucose control below 8.0 mmol/L in 60 cases （60/72） ; There was improvement in lesions absorption in 52 cases, sputum bacterium negative conversion for 1 month in 34 cases, negative conversion for 2 months in 5 cases, negative conversion for 3 months in 2 cases and negative conversion for 3 to 6 months in 3 cases ; Plasma glucose control above 8.0 mmol/L in 12 cases, and there were 5 cases with plasma glucose control above 11.1 mmol/L. Conclusions Patients of diabetes with pulmonary tuberculosis were tend to be younger, image feature was involved in more than multi-sections of lung, and cavity formation was more common with strong infectivity. The diseas should be effectively controlled.