复治肺结核合并糖尿病现状及影响因素

Prevalence and risk factors of diabetes mellitus among retreatment pulmonary tuberculosis patients

目的探讨复治肺结核合并糖尿病患者的影响因素,为制定肺结核合并糖尿病防治政策提供相关依据。方法2009年10月—2012年12月选择我国22家结核病定点医疗机构确诊并进行治疗的复治肺结核患者395例进行调查,按照是否合并糖尿病分为单纯复治肺结核组及合并糖尿病组,运用χ2检验比较两组患者在社会学特征等方面的差异,运用多因素非条件logistic回归分析肺结核合并糖尿病的危险因素。结果共纳入395例患者,其中合并糖尿病60例,占15.2%;单纯肺结核患者335例,占84.8%。两组患者在年龄(χ2=10.459,P=0.0053),体质指数(BMI)(χ2=15.070,P=0.0005),职业(χ2=11.620,P=0.0029),婚姻状况(χ2=9.999,P=0.0067)差异具有显著性。复治肺结核患者40~59岁年龄组和≥60岁年龄组,BMI<18.5(kg/m2)及BMI≥24.0(kg/m2),已婚是复治肺结核合并糖尿病的危险因素,OR(95%CI)值分别为2.159(1.050~4.439),5.017(1.485~16.951)、4.946(1.279~8.705)、5.732(1.918~17.133)及4.476(1.248~10.504)。结论复治肺结核合并糖尿病与患者的年龄、体重指数、婚姻状态有关。

Objective To explore tuberculosis - diabetes mellitus(DM) comorbidity and its risk factors among retreatment pulmonary tuberculosis patients(PTB) and to provide references for prevention and treatment of PTB-DM comorbidity.Methods We recruited 395 retreatment PTB patients at 22 medical institutions designated for PTB treatment across China and divided the patients into a PTB and a PTB-DM group according to the comorbidity of DM;then we carried out a questionnaire survey among all the patients from October 2009 to December 2012. Chi-square test was used to compare differences in demographics and other characteristics between the patients of the two groups;multivariate logistic regression analysis was used to explore risk factors of DM comorbidity. Results Of all the patients, 15.2%(60) were PTB-DM and84.8%(335) were simple PTB;there were significant differences between the two groups in age(χ2 = 10.459,P = 0.005 3),body mass index(BMI)(χ2 = 15.070,P = 0.000 5), occupation(χ2 = 11.620,P = 0.002 9) and marital status(χ2 = 9.999,P =0.006 7). Aged 40 - 59 years(odds ratio [OR] = 2.159, 95% confidence interval [95% CI]: 1.050 - 4.439), aged 60 years and above(OR = 5.017, 95% CI: 1.485 - 16.951), with a BMI of < 18.5 kg/m2(OR = 4.946, 95% CI: 1.279 - 8.705), with a BMI of ≥ 24 kg/m2(OR = 5.732, 95% CI: 1.918 - 17.133), and being married(OR = 4.476, 95% CI: 1.248 - 10.504) were significant risk factors of PTB-DM comorbidity. Conclusion The complication of diabetes mellitus is associated with age,body mass index, and marital status among retreatment pulmonary tuberculosis patients.