Morris J T, Seaworth B J, McAllister C K
Infectious Disease Service, Brooke Army Medical Center, Fort Sam Houston, Tex.
Chest. 1992 Aug;102(2):539-41. doi: 10.1378/chest.102.2.539.
Pulmonary tuberculosis is found predominantly in the lung apices. In diabetics it has been suggested that tuberculosis tended to occur predominantly in the lower lobes. A retrospective chart review was performed of all patients with a diagnosis of diabetes and pulmonary tuberculosis admitted to a health care facility to determine the presenting chest roentgenographic location of tuberculosis. Multiple lobe involvement was the predominant chest roentgenographic finding in both diabetics and nondiabetics with pulmonary tuberculosis. Since tuberculosis and diabetes frequently coexist in the population at risk for tuberculosis, clinicians should suspect tuberculosis in the diabetic with an abnormality on chest roentgenogram. Aggressive diagnostic measures and specific chemotherapy should be given and monitored to treat pulmonary tuberculosis.
肺结核主要见于肺尖。有观点认为，糖尿病患者的肺结核往往主要发生在肺下叶。对一家医疗机构收治的所有诊断为糖尿病合并肺结核的患者进行了回顾性病历审查，以确定肺结核在胸部X线片上的表现位置。在患有肺结核的糖尿病患者和非糖尿病患者中，多叶受累是胸部X线片的主要表现。由于在结核病高危人群中结核病和糖尿病经常并存，临床医生应对胸部X线片异常的糖尿病患者怀疑患有结核病。应采取积极的诊断措施并给予特异性化疗，并对治疗肺结核的情况进行监测。
