内源性硫化氢在糖尿病并肺结核患者中的变化及意义

Changes and significance of endogenous hydrogen sulfide in patients with diabetes mellitus complicated with pulmonary tuberculosis

目的探讨内源性硫化氢(H2S)在糖尿病并肺结核患者中的变化及意义。方法研究对象分成对照组、糖尿病组(DM组)、肺结核组(TB组)、糖尿病并肺结核组(DM&TB组)共4组,每组20例。对照组为体检的健康志愿者,DM组为单一2型糖尿病患者,TB组为单一肺结核患者,DM&TB组为2型糖尿病合并肺结核患者。DM组予以控制血糖,TB组予以抗痨治疗,DM&TB组予以控制血糖及抗痨治疗。记录各组患者年龄、性别。治疗前各组病例取血测H2S值、血沉(ESR)、C反应蛋白(CRP)、空腹血糖,TB组、DM&TB组治疗2个月、6个月复查H2S、ESR、CRP等。结果与对照组比较,治疗前DM组、TB组、DM&TB组患者H2S均明显降低,TB组、DM&TB组患者CRP、ESR显著增高(P<0.05);与TB组比较,DM&TB组H2S降低(P<0.05),CRP、ESR无显著差异,TB组、DM&TB组H2S与CRP、ESR呈显著负相关,DM组H2S与空腹血糖呈显著负相关(P<0.01)。DM&TB组治疗2个月、治疗6个月H2S均较治疗前明显增高,ESR、CRP均明显降低。结论内源性H2S在肺结核、糖尿病合并肺结核患者中均明显下降,且与ESR、CRP呈负相关。

Objective To investigate the changes and significance of endogenous hydrogen sulfide(H2S)in patients with diabetes mellitus complicated with pulmonary tuberculosis.Methods The subjects were divided into 4 groups:control group,diabetic group(DM group),pulmonary tuberculosis group(TB group)and diabetes complicated with pulmonary tuberculosis group(DM&TB group)with 20 cases in each group.The control group was healthy volunteers for physical examination,the DM group was a single type 2 diabetes patient,the TB group was a single pulmonary tuberculosis patient,and the DM&TB group was a type 2 diabetes mellitus complicated with pulmonary tuberculosis patient.Blood glucose was controlled in DM group,anti-tuberculosis treatment was given in TB group,and blood glucose control and anti-tuberculosis treatment were given in DM&TB group.The age and sex of patients in each group were recorded.Before treatment,H2S,ESR(ESR),C-reactive protein(CRP)and fasting blood glucose were measured in each group.H2S,ESR and CRP were reexamined in TB group and DM&TB group after 2 and 6 months treatment.Results compared with the control group,H2S in DM group,TB group and DM&TB group decreased significantly before treatment,while CRP and ESR in TB group and DM&TB group increased significantly(all P<0.05).Compared with TB group,H2S decreased in DM&TB group(P<0.05),CRP and (ESR).H2S in TB group and DM&TB group was negatively correlated with CRP and ESR,while H2S in DM group was negatively correlated with fasting blood glucose(P<0.01).In DM&TB group,H2S was significantly increased and ESR and CRP were significantly decreased after 2 and 6 months of treatment compared with those before treatment.Conclusion Endogenous H2S decreased significantly in patients with pulmonary tuberculosis and diabetes mellitus complicated with pulmonary tuberculosis,and negatively correlated with ESR and CRP.