Rawat Jagdish, Sindhwani Girish, Biswas Debasish
Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Lung India. 2011 Jul;28(3):187-90. doi: 10.4103/0970-2113.83975.
Diabetes mellitus (DM) has been reported to modify the presenting features of pulmonary tuberculosis (PTB), but data regarding the effect of diabetes on the presentation of PTB are highly variable.
To determine whether DM alters the demographic, clinical, and radiological manifestations of tuberculosis and whether the effect of diabetes varies with the age group of PTB patients.
This prospective observational study was conducted on new smear-positive PTB patients with DM (PTB-DM group) and non-diabetic PTB patients (PTB group). Patients of both groups were again divided into six age groups (15-29, 30-39, 40-49, 50-59, 60-69, and >70 rears) to analyze and compare the impact of age on clinicoradiological presentations of PTB.
Patients in the PTB-DM group were significantly older (53.34 ± 14.06 year) in comparison to their nondiabetic counterparts (PTB group) (44.35 ± 18.14 year) (P < 0.001). The former group also had a lower male:female ratio, although the difference was not statistically significant (1.16:1 vs. 2.05:1, P = 0.101). Tuberculin positivity was significantly higher in the PTB group, compared with patients in the PTB-DM group (P < 0.004). The proportion of patients with lower lung field involvement (P = 0.003) and cavitations (P = 0.005) was also higher in the former group compared with the latter.
Diabetic patients with tuberculosis were relatively older, had lower tuberculin positivity, and higher proportion of lower lung field involvement and cavitation in comparison to nondiabetic patients.
据报道,糖尿病(DM)会改变肺结核(PTB)的临床表现,但关于糖尿病对PTB表现影响的数据差异很大。
确定糖尿病是否会改变结核病的人口统计学、临床和放射学表现,以及糖尿病的影响是否因PTB患者的年龄组而异。
本前瞻性观察研究针对新的涂片阳性PTB糖尿病患者(PTB-DM组)和非糖尿病PTB患者(PTB组)进行。两组患者又分为六个年龄组(15 - 29岁、30 - 39岁、40 - 49岁、50 - 59岁、60 - 69岁和>70岁),以分析和比较年龄对PTB临床放射学表现的影响。
与非糖尿病患者(PTB组)(44.35±18.14岁)相比,PTB-DM组患者年龄显著更大(53.34±14.06岁)(P < 0.001)。前一组的男女比例也较低,尽管差异无统计学意义(1.16:1对2.05:1,P = 0.101)。与PTB-DM组患者相比,PTB组结核菌素阳性率显著更高(P < 0.004)。前一组下肺野受累(P = 0.003)和空洞形成(P = 0.005)患者的比例也高于后一组。
与非糖尿病患者相比,合并结核病的糖尿病患者年龄相对较大,结核菌素阳性率较低,下肺野受累和空洞形成的比例较高。