二甲双胍联合抗结核药物短期治疗肺结核合并2型糖尿病的临床效果

The clinical efficacy of metformin combined with anti-tuberculosis drugs in short-term treatment of pulmonary tuberculosis complicated with type 2 diabetes mellitus

目的:探讨二甲双胍(metformin,MET)联合抗结核药物短期治疗肺结核(pulmonary tuberculosis,PTB)合并2型糖尿病(type 2 diabetes mellitus,T2DM)的临床效果,为临床治疗提供参考。方法:收集2023年1—12月沧州市第三医院首次诊断PTB的T2DM患者70例,根据降糖方案中是否含有二甲双胍分为MET组和N-MET组。分析两组在治疗2、4周时空腹血糖(fasting blood glucose,FBG)、血沉(erythrocyte sedimentation rate,ESR)、CRP及胸部影像学的改变,并统计两组的肝功能异常发生率。结果:治疗4周时,MET组FBG、ESR、CRP水平较N-MET组下降更明显(t=-2.084、-3.144、-3.229,P=0.048、0.003、0.003),但两组患者病灶明显吸收率差异无统计学意义(P>0.05);相同时间内两组肝功能异常发生率差异无统计学意义(P>0.05)。结论:MET联合抗结核药物短期治疗PTB合并T2DM可以促进炎症指标下降,FBG尽快达标,但短期治疗对病灶吸收无明显优势,药物不良反应发生率并未增加。

Objective:To investigate the clinical efficacy of metformin(MET)combined with anti-tuberculosis drugs in the short-term treatment of pulmonary tuberculosis(PTB)complicated with type 2 diabetes mellitus(T2DM),and provide a reference for clinical treatment.Methods:The clinical data of 70 T2DM patients with primary PTB treated in Cangzhou Third Hospital from January to December 2023 were collected,and they were further divided into the MET group and the N-MET group according to whether MET was included in the hypoglycemic regimen.The changes in fasting blood glucose(FBG),erythrocyte sedimentation rate(ESR),CRP and chest imaging after 2 and 4 weeks of treatment were analyzed and compared between the two groups,and the incidence of abnormal liver function of the two groups were counted.Results:After 4 weeks of treatment,FBG,ESR and CRP in the MET group were lower than those in the N-MET group,and the differences were statistically significant(t=-2.084,-3.144,-3.229;P=0.048,0.003,0.003).There was no significant difference in the absorption rate of lesions between the two groups(P>0.05).There was no significant difference in the incidence of abnormal liver function between the two groups at the same time(P>0.05).Conclusion:A short-term use of MET and anti-tuberculosis drugs in the treatment of PTB with T2DM can promote a decrease in inflammatory markers and the target of FBG as soon as possible.However,this short-term treatment approach has no obvious advantage in the absorption of lesions.The incidence of adverse drug reactions does not increase.