不同血糖控制水平对糖尿病合并肺结核患者抗结核疗效的影响

The Effect of Different Blood Glucose Control Levels on the Anti-tuberculosis Curative Effect of Patients with Diabetes and Pulmonary Tuberculosis

目的探讨不同血糖控制水平对糖尿病合并肺结核患者抗结核疗效的影响。方法方便选择2019年1月—2020年12月该中心登记的102例糖尿病合并肺结核患者作为研究组,选择同期该中心登记的98例单纯肺结核患者作为对照组。两组患者均进行抗结核治疗,研究组同时接受降糖方案治疗。比较两组患者肺结核病灶吸收、痰菌转阴率、不良反应情况;研究组治疗前后血糖指标的变化,以及不同血糖控制情况患者的肺结核病灶吸收与痰菌转阴率。结果研究组肺结核病灶吸收率80.39%、痰菌转阴率74.51%低于对照组的96.94%、94.90%,差异有统计学意义(χ^(2)=13.445、15.862,P<0.05)。治疗后,研究组空腹血糖(5.80±0.20)mmol/L、餐后2 h血糖(6.89±0.19)mmol/L与糖化血红蛋白(5.68±0.32)%均低于治疗前(8.28±0.59)mmol/L、(11.02±0.68)mmol/L、(7.56±0.47)%,差异有统计学意义(t=40.205、59.077、33.393,P<0.05)。血糖控制良好亚组肺结核病灶吸收率89.33%、痰菌转阴率85.33%高于血糖控制不良亚组55.56%、59.26%,差异有统计学意义(χ^(2)=14.370、7.979,P<0.05)。研究组治疗期间的不良反应发生率7.84%与对照组5.10%对比,差异无统计学意义(χ^(2)=0.618,P>0.05)。结论积极控制血糖水平能够有效提高糖尿病合并肺结核患者的抗结核疗效,临床应重视此类患者的血糖管理工作,以保障整体治疗效果。

Objective To investigate the effect of different blood glucose control levels on the anti-tuberculosis efficacy of patients with diabetes and pulmonary tuberculosis.Methods From January 2019 to December 2020,102 patients with diabetes and tuberculosis registered in the center were conveniently selected as the study group.98 cases of simple tuberculosis patients registered in the center during the same period were selected as the control group.Both groups of patients were treated with anti-tuberculosis,and the study group received treatment with hypoglycemic regimens at the same time.Compared the absorption of pulmonary tuberculosis lesions,the rate of negative conversion of sputum bacteria,and adverse reactions between the two groups.The changes in blood glucose indicators before and after treatment in the study group,as well as the absorption of pulmonary tuberculosis lesions and the negative rate of sputum bacteria in patients with different blood glucose control conditions.Results The absorption rate of pulmonary tuberculosis lesions in the study group was 80.39%,and the negative rate of sputum bacteria was 74.51%lower than that of the control group 96.94%and 94.90%,and the difference was statistically significant(χ^(2)=13.445,15.862,P<0.05).After treatment,the study group's fasting blood glucose(5.80±0.20)mmol/L,2 h postprandial blood glucose(6.89±0.19)mmol/L and glycosylated hemoglobin(5.68±0.32)%were all lower than before treatment(8.28±0.59)mmol/L,(11.02±0.68)mmol/L,(7.56±0.47)%,and the difference was statistically significant(t=40.205,59.077,33.393,P<0.05).The absorption rate of pulmonary tuberculosis lesions in the subgroup with good blood glucose control was 89.33%,and the rate of negative conversion of sputum bacteria was 85.33%higher than that of the subgroup with poor blood glucose control by 55.56%and 59.26%,and the difference was statistically significant(χ^(2)=14.370,7.979,P<0.05).The incidence of adverse reactions during treatment in the study group was 7.84%compared with 5.10%in the control group,and the difference was not statistically significant(χ^(2)=0.618,P>0.05).Conclusion Active control of blood glucose level can effectively improve the anti-tuberculosis curative effect of patients with diabetes and pulmonary tuberculosis.The clinic should pay attention to the blood glucose management of such patients to ensure the overall treatment effect.