1型与2型糖尿病肺结核患者临床及影像学特点分析

Clinical features of pulmonary tuberculosis patients with type 1 and type 2 diabetes mellitus

关键词:  1型糖尿病  2型糖尿病  肺结核

Key words:  type 1 diabetes mellitus  type 2 diabetes mellitus  pulmonary tuberculosis

摘要:

目的　比较1型糖尿病与2型糖尿病肺结核患者的临床及影像学特点。 方法　收集2013-2017年间大连市结核病医院33例1型糖尿病、89例2型糖尿病及106例非糖尿病肺结核患者的临床资料，比较三组患者之间临床及影像学方面的差异性。结果　三组患者均以男性为主，1型糖尿病肺结核患者HbA1C明显高于2型糖尿病肺结核患者(P＜0.05)；影像学方面，相对于非糖尿病肺结核患者而言，糖尿病肺结核患者渗出性病变及多发空洞征象更为多见(P＜0.05)，但1型糖尿病与2型糖尿病肺结核患者之间无明显差异性(P＞0.05)。不良反应方面三组之间无明显差异性(P＞0.05)。疗效方面，1型糖尿病肺结核患者2个月痰结核菌涂片阴转率低于非糖尿病肺结核组，但三组患者治愈率无明显差异性(P＞0.05)。结论　相对于非糖尿病肺结核患者而言糖尿病肺结核患者在影像学方面实变及空洞征象多见。1型与2型糖尿病肺结核患者在影像学、药物不良反应及治愈率方面无明显差异性，但1型糖尿病肺结核患者血糖不易控制；2个月痰结核菌涂片阴转率低。

Abstract:

Objective To study the clinical features of pulmonary tuberculosis patients（PTB）with type 1 （T1DM） and type 2 diabetes mellitus （T2DM）. Methods The data of 33 cases with T1DM PTB, 89 cases with T2DM PTB, 106 nondiabetic PTB at Dalian Tuberculosis Hospital were collected from 2013 to 2017. The differences of clinical and imaging features among the three groups were compared. Results HbA1c level in T1DM PTB patients was higher than that in T2DM PTB patients (P<0.05). The signs of exudative lesion and multiple cavities in imaging were more frequent in DM TB patients compared with nondiabetic PTB cases (P<0.05), but no significant difference was found between T1DM and T2DM PTB cases(P＞0.05). The side-effects were no significantly different among the three groups(P＞0.05). Smear-conversion after receiving 2 months of anti-TB treatment in T1DM PTB patients was lower than that of nondiabetic PTB cases, but the cure rate was not significantly different among them (P＞0.05). Conclusion Signs of consolidation and multiple cavities were more frequent in DM PTB patients. No significant difference was found between T1DM and T2DM PTB cases in imaging, side-effects and cure rate, but control of hyperglycemia is more difficult among T1DM PTB patients and sputum conversion rate was lower after 2 months treatment.