北京市两区糖尿病合并肺结核人群流行病学特征分析

目的了解北京市两个郊区糖尿病合并肺结核人群(DM-PTB)的流行病学特征,为下一步开展相关防控工作提供依据。方法收集北京市两个近郊区结核病防治所2010-2011年登记管理的肺结核患者资料,描述糖尿病合并肺结核病患者的流行病学特征。结果本研究共纳入有效研究对象肺结核患者1 126例,其中DM-PTB患者182例,占16.16%。DM-PTB患者平均年龄54岁,以中老年患者为主,男女比例约为2.3∶1;DM-PTB患者出现咳嗽(76.37%)和咳痰(60.44%)症状的比例最高;DM-PTB患者涂阳率为53.85%,胸片空洞比例为39.44%,非结核死亡、失败、不良反应或转入耐多药治疗等不良转归所占百分比为13.80%,均显著高于同期单纯PTB患者(χ2=10.61,P﹤0.01)。结论北京市两近郊区DM-PTB患病率高,DM-PTB患者较单纯肺结核患者临床表现更为严重,且预后较差。应及时开展双向筛查工作,及早发现并控制肺结核疫情的传播。

Epidemiological features of pulmonary tuberculosis in patients with diabetes mellitus in two districts of Beijing

Objective To understand the epidemiological features of pulmonary tuberculosis （PTB） in patients with diabetes mellitus （DM） in two districts of Beijing, and to provide evidence for prevention and control. Methods Data of PTB patients registered from 2010 to 2011 in two suburbs of Beijing were collected and the epidemiological features of DM-PTB were described as well. Results A total of 1126 PTB patients were en- rolled, and 182 （16.16%） with DM were identified. The average age of DM-PTB patients was 54 years and the male to female ratio was 2.3 ： 1. The two most common symptoms of DM PTB patients were cough （76.37%） and sputum （60.44%） . Among 182 DM-PTB patients, 53.85% were smear positive, 39.44% showed cavity on chest radiography and 13.80% had poor treatment outcomes, which were all significantly higher compared to patients with only PTB （P〈0.01）. Conclusions The prevalence of DM-PTB is high in the two districts of Beijing, and the clinical manifestation is more serious and the prognosis is worse in DM- PTB patients than in patients without DM. Therefore, the hi-directional screening for PTB and DM should be carried out to control the epidemic of tuberculosis.