胰岛素强化治疗糖尿病合并初治肺结核的疗效观察

目的探讨胰岛素皮下注射强化治疗糖尿病合并肺结核的疗效。方法 58例糖尿病合并初治肺结核患者均采用胰岛素强化治疗（三餐前短/速效胰岛素,睡前中/长效胰岛素皮下注射）,观察血糖控制情况（每日4次指尖血糖）、糖化血红蛋白（HbA1c）、低血糖反应,治疗后结核病的病菌转阴情况及结核病灶的X线、CT变化。结果 1~3个月后血糖、HbA1c控制水平满意,痰菌转阴86%,病灶吸收满意。结论糖尿病合并肺结核时,在规律抗结核治疗前提下,应尽早使用胰岛素强化治疗,使血糖及HbA1c控制更为满意,在此基础上才能提高结核患者的治愈好转率。

The efficacy of intensive insulin therapy in diabetes mellitus complicated with pulmonary tuberculosis

Objective To evaluate the efficacy of Diabetes Mellitus complicated with new pulmonary tuberculosis treated by intensive insulin subcutaneous injection therapy. Methods Fifty eight patients diabetes mellitus complicated with pulmonary tuberculosis all treated by insulin (Pre-meal short-effective insulin/insulin before meals, Bedtime NPH insulin subcutaneous injection/ Bedtime insulin subcutaneous injection). Observed the items as follow: blood glucose fluctuation, HbA1c fluctuation, hypoglycemic reaction. Meanwhile, the rates of sputum negative conversion, and lung focus shrinking were also observed. Results For three months, Glucose and HbA1c control levels of satisfaction(the blood glucose of the finger tips four times every day),the rate of sputum negative conversion was 86%,and lung focus shrinking on chest X-ray or CT. Conclusion Patients with DM complicated with PTB were treating by anti tuberculosis; they should be using intensive insulin therapy, so that their blood glucose and HbA1c were satisfied. Doing so can improve patients’ healing rate.