肺结核病合并2型糖尿病患者的痰涂片抗酸染色阳性率分析

Positive rate of acid fast bacilli smear in patients with pulmonary tuberculosis complicated with type 2 diabetes mellitus

目的探讨合并2型糖尿病在诊断对肺结核病患者痰涂片抗酸染色阳性检出率的影响。方法回顾性纳入225例2012年1月至2016年12月在我院治疗的肺结核病患者,根据随机血糖(≥11.1mmol/L)或空腹血糖(≥7.0 mmol/L)将肺结核病患者分为糖尿病组(81例)和非糖尿病组(144例),比较两组临床症状体征、痰涂片抗酸染色阳性检出率等差异。结果糖尿病组的痰涂片抗酸染色阳性率高于非糖尿病组(54.3%vs 22.2%,P<0.001),咯血发生率也高于非糖尿病组(71.6%vs 56.3%,P=0.023),但两组的持续性咳嗽、呼吸困难、体重减轻、厌食、盗汗、胸痛、发热等症状及体重差异,无统计学意义(P>0.05)。随机血糖≥11.1mmol/L、空腹血糖≥7.0 mmol/L和餐后2h血糖≥11.1mmol/L患者的痰涂片抗酸染色阳性检出率分别增加4.179、4.220和4.696倍(均P<0.05),并且合并糖尿病能够提高痰涂片抗酸染色阳性检出率4.762倍(P<0.001)。结论合并2型糖尿病的肺结核病患者的痰涂片抗酸染色阳性率明显高于非糖尿病患者。

Objective To investigate the effect of type 2 diabetes mellitus(DM)diagnosis on the positive rate of acid fast bacilli smear in patients with pulmonary tuberculosis.Methods It retrospectively enrolled 225 patients diagnosed with pulmonary tuberculosis from January 2012 to December 2016.All patients were divided into the diabetic group(81 cases)and the non-diabetic group(144 cases)according to random blood glucose(≥11.1 mmol/L)or fasting blood glucose(≥7.0 mmol/L).The clinical symptoms and signs and the positive rate of acid fast bacilli smear were compared between the two groups.Results The positive rate of acid fast bacilli smear in the diabetic group was significantly higher than that in the non-diabetic group(54.3% vs 22.2%,P<0.001),and the incidence of hemoptysis in the diabetic group was also significantly higher than that in the non-diabetic group(71.6% vs 56.3%,P=0.023),but there was no statistical difference in persistent cough,dyspnea,weight loss,anorexia,night sweats,chest pain and fever(P>0.05).The positive rate of acid fast bacilli smear in patients with random blood glucose ≥11.1 mmol/L,fasting blood glucose ≥7.0 mmol/L,or 2h postprandial blood glucose ≥11.1 mmol/L increased by 4.179,4.220 and 4.96 times,respectively(P<0.05).And the diagnosis of diabetes could increase the positive rate of acid fast bacilli smear up to 4.762 times(P<0.001).Conclusion The positive rate of acid fast bacilli smear in pulmonary tuberculosis patients with type 2 DM is significantly higher than that of non-diabetic patients.