糖尿病合并肺结核患者血清25（OH）D3水平与临床特点分析

Analysis of Serum 25（OH）D3 Level and Clinical Characteristics in Patients with Diabetes Mellitus Complicated with Tuberculosis

目的观察糖尿病合并肺结核患者血清25(OH)D3水平与临床特点。方法选择2016年1月至2017年12月期间住院确诊的初治糖尿病合并肺结核患者为观察组,初治肺结核患者作为对照组,每组各80例,检测两组的痰结核菌涂片、血清25(OH)D3、HbA1c、空腹血糖、空腹胰岛素水平、观察肺CT病灶特点。结果组间比较性别构成和年龄,差异无统计学意义。观察组痰结核菌涂片阳性率、HbAlc、病变程度均高于对照组,差异有统计学意义(P<0.05);观察组25(OH)D3均低于对照组,差异有统计学意义(P<0.05);观察组内,高血糖组涂阳率高于血糖控制理想组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,25(OH)D3与病灶严重程度、HbA1c、空腹胰岛素水平呈负相关(P<0.05)。结论低浓度维生素D的糖尿病患者血糖控制不理想、易患肺结核,且表现痰菌阳性率高,肺部病变重,多易形成空洞。

Objective To observe the serum 25 (OH) D3 level and clinical characteristics of diabetic patients with pulmonary tuberculosis. Methods 80 patients with newly diagnosed diabetes mellitus and pulmonary tuberculosis were selected as observation group and 80 patients with pulmonary tuberculosis as control group from January 2016 to December 2017. The sputum smears, serum 25 (OH) D3, HbA1c, fasting blood sugar, fasting insulin levels and the characteristics of pulmonary CT were detected. Results There was no significant difference in sex composition and age between groups. The positive rate of sputum tuberculosis smear, HbA1c and pathological changes in the observation group were higher than those in the control group, with statistical significance (P<0.05);the 25 (OH) D3 in the observation group was lower than that in the control group, with statistical significance (P<0.05);in the observation group, the smear positive rate in the hyperglycemia group was higher than that in the ideal blood sugar control group, with statistical significance (P<0.05). Pearson correlation analysis showed that 25 (OH) D3 was negatively correlated with lesion severity, HbA1c and fasting insulin levels (P<0.05). Conclusion Diabetic patients with low concentration of vitamin D have poor blood sugar control, susceptible to tuberculosis, high positive rate of sputum bacteria, severe pulmonary lesions and voids.