糖尿病合并肺结核病四年追踪观察报告

目的　探讨糖尿病患者肺内陈旧性结核病灶与合并肺结核病发生率的关系。方法　 2 2 6例确诊为糖尿病但无肺结核病的患者按观察期前 2周内胸片检查是否发现有陈旧性结核病灶征象 ,分为可能复燃队列和可能新发队列 ,经 4年追踪观察 ,分析两队列合并肺结核病的发生率及血糖水平、血糖波动持续时间的作用。结果　合并肺结核病患者 33例 (13.5 % )。可能新发队列合并肺结核病的发生率为 9.1% ,可能复燃队列合并肺结核病的发生率为 32 .6 % ,相对危险度为 3.5 8,归因危险度比率为 72 .0 9%。可能复燃队列中合并了肺结核病患者的血糖水平高于未合并肺结核患者。合并肺结核病患者的血糖波动持续时间比合并其他感染患者相对较长 (>2周 )。结论　肺结核陈旧性病灶在糖尿病患者合并肺结核病的发生过程中起着重要的作用 ,彻底治疗肺结核对控制糖尿病患者肺结核复燃有十分重要的意义。控制好血糖是防治合并肺结核病的关键

Pulmonary Tuberculosis in Patients with Diabetes Mellitus :-a Follow-up for 4 Years

Objective To investigate the incidence of the cured pulmonary tuberculosis(PT)relapse in patients with diabetes mellitus.Methods Refering to the previous chest X-ray finding,226 diabetics were divided into the group of potential relapse with a X-ray of previous cured PT lesion and the group of potential first attack with a negative X ray examination.During the follow-up,the chest X-ray examination was taken twice a year and the levels of fasting plasma glucose(FPG),postprandial blood glucose(2 h PPG)and HbA1c were measured.The incidence of PT was observed.Results The incidence of PT was 32.6% in the group of potential relapse and 9.1% in the group of potential first attack.The relative risk was 3.58 and the attribution risk is 72.09% in the group of potential relapse.Conclusion The effect of previous cured PT lesion is significant in the cause pulmonary tuberculosis in patients with diabetes mellitus,and the previous pulmonary lesion should be treated thoroughly.