肺结核并存糖尿病346例临床分析

目的: 总结肺结核并存糖尿病患者的临床特点及诊疗方法。方法: 对346例肺结核并存糖尿病患者进行回顾性分析。结果: 肺结核并存糖尿病呈增高趋势,且以中老年患者多发。女性多于男性(P<0.05),具有病灶范围广泛,以干酪性病灶为主,多伴有空洞,痰菌阳性率高,治疗效果差,复治患者多的临床特点。以并存2型糖尿病为主,早期应用胰岛素组病灶吸收,痰菌阴转率和空洞闭合优于口服降糖组(P<0.05~P<0.005)。抗结核疗程需1.5~2年。结论: 肺结核并存糖尿病患者具有一定的临床特点。有效控制血糖是治疗成功的关键,早期应用胰岛素比口服降糖药疗效好。

Clinic analysis of pulmonary tuberculosis coexist with diabetes mellitus:Report of 346 cases

Objective: To summarize the clinical features of pulmonary tuberculosis complicated with diabetes mellitus and to improve the treatment effects. Methods: The clinical data of 346 patients suffering from pulmonary tuberculosis accompanied with diabetes mellitus were analyzed retrospectively. Results: The incidence of pulmonary tuberculosis comlicated with diabetes mellitus tended to increase in the middle aged and elderly people. Women were more easily affected than men (P<0.05). Specific features included wide spreading of the focuses of infection, which were mainly in the caseous form and accmpanied by cavity, high positive rate of bacteriologic sputum, poor curative result and high occurrence of relapse. Most of the patients had type 2 diabetes mellitus mellitus. Early use of insulin might achieve better results than oral medicine in symptom improvement, cavity closure and the rate of sputum turning to negative (P<0.05-P<0.005). The treatment duration lasted for 1.5-2.0 years. Conclusions: The patients with pulmonary tuberculosis complicated with diabetes mellitus have special clinical features. Control of blood glucose is the key for successful treatment. Early insulin has better treatment effects than oral medication.