糖尿病肺结核患者肺部病灶与血糖水平相关性的探讨

Correlation Study of Diabetic Patients with Pulmonary Tuberculosis Pulmonary Lesions and the Levels of Glucose

目的探讨糖尿病肺结核患者的影像学表现以及血糖水平与肺部病灶动态变化的相关性。方法回顾性分析2010年6月至2012年4月在我院证实的62例糖尿病肺结核患者血糖水平与肺部病灶动态变化的关系,并随机抽取50例单纯肺结核患者的影像学资料作对照,比较分析两组患者的影像学表现。结果糖尿病组与对照组相比,病灶累单个肺叶10例(16%),对照组42例(84%);2个以上肺叶受累52例(84%),对照组8例(16%);糖尿病组散在斑片状影16例(26%),融合的片状影25例(40%),肺实变19例(31%),空洞28例(45%),粟粒型肺结核2例(3%),对照组散在斑片状影41例(82%),融合的片状影6例(12%),肺实变3例(6%),空洞13例(26%),无粟粒型肺结核,两组差异具有统计学意义(P<0.05)。糖尿病组病例血糖在6个月内得到控制54例(87%),其中病灶吸收缩小48例(89%),病灶范围无明显改变2例(4%),病灶范围扩大4例(7%)。血糖控制差的8例中有1(12.5%)例病灶范围无明显改变,1例(12.5%病灶吸收缩小,病灶范围扩大6例(75%),两组差异具有统计学意义(P<0.05)。对照组与血糖控制良好组无显著性差异。结论糖尿病合并肺结核的影像学表现具有病灶分布广、形态多种多样并多呈中、重度表现,有效的控制血糖有助于肺结核的治疗。初诊肺结核患者肺部病灶较严重以及治疗效果不显著者应及时进行糖尿病的相关检查,明确诊断以免延误治疗。

Objective To investigate the diabetic patients with tuberculosis of the imaging findings and the level of blood glucose and the dynamic correlation between changes in pulmonary lesions. Methods A retrospective analysis of 2010June to＇ 2012April in our hospital confirmed pulmonary tuberculosis in 62 diabetic patients blood glucose levels and lung dynamic relationships, and a random sample of 50cases of pulmonary tuberculosis in patients with neuroimaging data for comparison, the comparison and analysis of two groups of patients with imaging findings. Results The diabetic group compared with the control group,10 cases were tired single lobe （16%）,42 cases in the control group （84%）; more than 2lobe was involved in 52 cases （84%）,8 cases in the control group （16%）; diabetes group scattered in patchy shadow in 16 cases （26%）, fusion patchy shadow 25cases （40%）, the consolidation of lung in 19 eases （31%）, cavity in 28 patients （45%）, miliary pulmonary tuberculosis in 2 eases （3%）, the control group scattered in patchy shadow in 41 eases （82%）, fusion of the schistose image in 6 cases （12%）, the consolidation of lung in 3 cases （6%）, cavity in 13 patients （26%）, no miliary tuberculosis, two group difference has statistics significance （P〈0.05）. Diabetic patients blood glucose within 6 months control in 54 patients （87%）, in which the lesions absorbed reduced in 48 cases （89%）, the extent of the lesion showed no change in 2 patients （4%）, was widened in 4 patients （7%）. Poor glyeaemic control in 8 cases out of 1（12.5%） cases had no obvious change range,1 cases （12.5% lesions absorption is reduced, the extent of the lesion enlarged in 6 cases （75%）, the two group difference has statistics significance （P〈0.05）. The control group with good glycemic control group showed no significant difference. Conclusion The image of pulmonary tuberculosis with diabetes mellitus with wide distribution, lesion morphology varied and many were, severe manifestations, effective glycemic control contributes to the treatment of pulmonary tuberculosis. Newly diagnosed patients with pulmonary tuberculosis pulmonary lesions and treatment of serious effect should be timely diabetes related examination, diagnosis so as not to delay treatment.