2型糖尿病患者并发肺结核营养治疗后对痰液结核分枝杆菌阴转及免疫功能的影响

Effect evaluation of individual medical nutrition therapy on sputum negative conversion of Mycobacterium tuberculosis and immunity in type 2 diabetes mellitus patients with tuberculosis

目的探讨2型糖尿病并发肺结核感染患者营养治疗后对痰液结核分枝杆菌阴转及免疫功能的影响,以提高临床治愈率。方法选择2012年1月-2014年6月82例2型糖尿病并发肺结核住院患者为研究对象,将其按照入院时间的先后分为对照组42例和观察组40例,观察两组患者痰液结核分枝杆菌阴转率及肺部感染率。结果观察组生化指标水平明显较治疗前改善与降低,改善与降低幅度高于同期对照组,差异均有统计学意义(P<0.05);观察组CD4+、CD4+/CD8+淋巴细胞数值明显较治疗前提升,CD8+数值明显较治疗前降低,提升与降低幅度高于同期对照组,差异均有统计学意义(P<0.05);观察组治疗后1、3、6个月痰液结核分枝杆菌阴转率优于同期对照组,差异有统计学意义(P<0.05);观察组肺部感染率2.50%明显低于对照组16.67%,差异有统计学意义(χ2=4.6702,P<0.05)。结论对2型糖尿病并发肺结核患者实施个体化医学营养治疗,提高免疫功能,降低感染率。

OBJECTIVE To study effects of individualized medical nutrition therapy on sputum negative conversion of Mycobacterium tuberculosis and immunity in type 2 diabetes mellitus patients with tuberculosis,so as to increase clinical curative rate.METHODS Totally 82 cases of type 2diabetes patients with pulmonary tuberculosis in the department of nutriology,Guangfu Hospital of Jinhua during Jan.2012-Jun.2014 were selected as the subjects and divided into the control group（42cases）and the observation group（40cases）by admission time.The sputum negative conversion rate of M.tuberculosis and pulmonary infection rate of the two groups were observed.RESULTS The levels of biochemical indicators were significantly improved in the observation group compared with before treatment,and the improvement and reduction were greater than the control group in the same period（P〈0.05）.The levels of blood sugar and glycosylated hemoglobin were significantly decreased in the observation group compared with before treatment,and the magnitude of decrease was greater than the control group in the same period（P〈0.05）.CD4^＋,CD4^＋/CD8^＋,and lymphocytes were significantly increased in the observation group than before treatment,and CD8^＋was significantly lower in the observation group than before treatment,the decrease and improvement were greater at 1,3,and 6months of treatment than the control group in the same period（P〈0.05）.The pulmonary infection rate of the observation group（2.50%）was significantly lower than the control group（16.67%）（χ^2=4.6702,P〈0.05）.CONCLUSIONThe implementation of individualized medical nutrition therapy in type 2diabetes patients with pulmonary tuberculosis can improve the immune function and decrease infection rate.