糖尿病合并肺结核患者饮食治疗依从性与病情控制关系的调查分析

Survey on the relationship between dietarytherapy compliance of diabetes mellitus patients with pulmonary tuberculosis and glycemic control

目的 探讨糖尿病合并肺结核患者饮食治疗依从性与病情控制的关系.方法 采用问卷调查的方式,根据饮食治疗依从性好、中、差将136例糖尿病合并肺结核患者分为1、2、3组,对患者饮食治疗的依从性、血糖水平、体质量指数(BMI)、痰菌转阴率、病灶吸收率进行调查分析.结果 136例患者中,1组(依从性好)、2组(依从性中等)、3组(依从性差)分别有32例(23.5％)、62例(45.6％)、42例(30.9％).3组患者总体的空腹血糖(FBG)为(8.36±1.62) mmol/L、餐后2h血糖(PBG)为(10.43±1.69) mmol/L、糖化血红蛋白(HbA1c)为(8.15±0.99)％、BMI为(20.46±1.68) kg/m2、痰菌转阴率为55.9％(76/136)、病灶吸收率为46.3％(63/136).3组患者比较,FBG(F=34.01,P＜ 0.01)、PBG(F=30.77,P＜ 0.01)、HbA1c(F=32.35,P＜ 0.01)、BMI(F=16.29,P＜ 0.01)、痰菌转阴率(x2=10.49,P＜0.05)、病灶吸收率(x2=7.47,P＜0.05)差异均有统计学意义.糖尿病病程(x2=18.14,P＜ 0.01)、文化程度(x2=21.04,P＜0.01)是饮食治疗依从性的影响因素.结论 糖尿病合并肺结核患者饮食治疗依从性较低,病情控制不理想,应加强对患者的健康教育,提高患者饮食治疗的依从性,从而改善患者的病情控制水平,提高治疗效果.

Objective To investigate the relationship between dietarytherapy compliance of diabetes mellitus patients with pulmonary tuberculosis and glycemic control.Methods According to the three levels (good,medial and bad) of dietary therapy compliance,136 diabetesmellituspatients with pulnonary tuberculosis were divided into three groups signed by group 1 (good compliance),2 (medial compliance) and 3 (bad compliance).Questionnaire survey was appliedto respectively investigate the blood glucose level,body mass index,the sputum negative conversion rate and loci absorption rate of the patients in those groups.Results Of the 136 patients,group 1 had 32 (23.5％) patients,while group 2 had 62 (45.6％)patients,group 3 had 42 (30.9％) patients.Among these three groups,the fasting blood glucose (FBG) was (8.36±1.62) mmol/L,the postprandial 2h blood glucose (PBG) was (10.43±1.69) mmol/L,the HbAlc was (8.15±0.99)％,the body mass index (BMI) was (20.46±1.68) kg/m2,the sputum negative conversion rate was 55.9％ (76/136),foci absorption rate was 46.3％ (63/136).The comparisons of the three groups on FBG (F=34.01,P＜ 0.01),PBG (F=30.77,P＜ 0.01),HbA1c (F=32.35,P＜ 0.01),BMI (F=16.29,P＜0.01),the sputum negative conversion rate(x2=10.49,P ＜ 0.05),foci absorption rate(x2=7.47,P ＜ 0.05) had statistical significance.Thecourse of diabetes (x2=18.14,P＜ 0.01) and patients' literacy (x2=21.04,P＜ 0.01) were both influence factors of dietarytherapy compliance.Conclusions Dietarytherapy compliance of diabetes mellitus patients with pulmonary tuberculosis is low and the glycemic control of those patients is poor.The situation of glycemic control and the therapeutic effect,the education about health to patients should be enhanced to make the dietarytherapy compliance better.