肺结核合并糖尿病的临床分析

目的探讨肺结核合并糖尿病的临床体征、肺部特征、影像学检查特征、实验室检查情况。方法选取本院2008年1月至2012年12月收治的肺结核合并糖尿病患者56例,对这些患者的临床诊断、检查资料进行回顾性总结分析。结果本组56例患者肺结核的临床症状表现为咳嗽30例（53.57%）,发烧16例（28.57%）,胸部疼痛20例（35.71%）,咯血10例（17.86%）,四肢乏力16例（28.57%）,胸腔积液8例（14.29%）,没有明显症状14例（25%）;本组患者临床肺部体征表现为呼吸音减弱11例（19.64%）,湿罗音18例（32.14%）,没有肺部体征27例（48.21%）;胸部DR影像学检查表现存在肺叶或段状分布的实质性病变或者肺不张特征40例（71.43%）,结节或者肿块样病变15例（26.79%）,不典型空洞21例（37.5%）,弥漫性粟粒结节3例（5.36%）;实验室检查表现白细胞升高24例（25%）,白细胞减少4例（7.14%）,血沉增快48例（85.71%）,结核菌素试验强阳性38例（67.86%）。结论对于肺结核合并糖尿病病例的临床诊断应进行相关检查并结合患者的临床体征进行综合判断。

Clinical analysis pulmonary tuberculosis with diabetes

Objective To investigate the clinical signs,features,image examination and laboratory examination characteristics of pulmonary tuberculosis with diabetes.Methods The data of clinical diagnosis,examination of fifty-six cases of pulmonary tuberculosis with diabetes from January,2008 to December,2012 were retrospectively analyzed.Results Among these patients,56 cases of patients with clinical symptoms such as cough in 30 cases （53.57%）,fever in 16 cases（28.57%）,chest pain in 20 cases（35.71%）,haematemesis in 10 cases（17.86%）, limb weakness in 16 cases（28.57%）,thoracic hydrops in 8 cases（14.29%）,no obvious symptoms in 4 cases （25%）.The clinical physical signs of the lungs showed decreased breath sounds in 11 cases（19.64%）,moist rales in 18 cases（32.14%）,no pulmonary symptoms in 27 cases（48.21%）.DR image performance in the presence of lobar or segmental distribution of the essence lesions or atelectasis features of 40 cases（71.43%）,nodular or mass lesions in 15 cases（26.79%）,atypical cavity in 21 cases（37.5%）,diffuse miliary nodules in 3 cases（5.36%）.The laboratory examination showed the increase of white blood cell in 24 cases（25%）,leucopenia in 4 cases（7.14%）, erythrocyte sedimentation rate increased in 48 cases（85.71%）,strongly tuberculin test was positive in 38 cases （67.86%）.Conclusion The clinical diagnosis of pulmonary tuberculosis with diabetes cases should be related with clinical signs in patients with inspection and comprehensive judgment.