Chen H-G, Liu M, Jiang S-W, Gu F-H, Huang S-P, Gao T-J, Zhang Z-G
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
National Center for Tuberculosis Control and Prevention, China Center for Disease Control and Prevention, Beijing, China.
Int J Tuberc Lung Dis. 2014 Mar;18(3):267-71. doi: 10.5588/ijtld.13.0140.
Delays in the diagnosis of pulmonary tuberculosis (PTB) increase the risk of transmission and severity of the disease. Little information is available on PTB patients with diabetes mellitus (DM).
To examine the impact of DM on delays in diagnosing PTB and the effect of diagnostic delay on the clinical presentation of PTB among patients in Beijing, China.
In a cross-sectional study conducted in two PTB dispensaries of Beijing, all confirmed PTB patients were screened for DM. Data relating to diagnostic delay and clinical presentation of PTB were collected and analysed.
Of 1126 PTB patients selected, 182 (16.2%) were identified as having DM. The median delay for PTB patients with DM (25 days) was significantly higher than that of PTB patients without DM (6 days). In a subgroup analysis, diagnostic delay was associated with smear positivity among PTB patients with DM (OR 3.10, 95%CI 1.66-5.76) and associated with smear positivity (OR 4.38, 95%CI 3.19-6.04), pulmonary cavities (OR 2.62, 95%CI 1.85-3.71) and more symptoms (OR 1.81, 95%CI 1.20-2.73) among PTB patients without DM.
DM was associated with longer diagnostic delays, which in turn was associated with more serious clinical presentations of PTB. It is thus necessary to examine risk factors associated with diagnostic delay among PTB patients with and without DM.
肺结核（PTB）诊断延误增加了疾病传播风险和严重程度。关于合并糖尿病（DM）的肺结核患者的信息较少。
探讨DM对中国北京肺结核患者诊断延误的影响以及诊断延误对肺结核临床表现的影响。
在北京两家肺结核诊疗所进行的一项横断面研究中，对所有确诊的肺结核患者进行DM筛查。收集并分析与肺结核诊断延误和临床表现相关的数据。
在选取的1126例肺结核患者中，182例（16.2%）被确诊患有DM。合并DM的肺结核患者的中位延误时间（25天）显著高于未合并DM的肺结核患者（6天）。在亚组分析中，诊断延误与合并DM的肺结核患者涂片阳性相关（比值比3.10，95%置信区间1.66 - 5.76），与未合并DM的肺结核患者涂片阳性（比值比4.38，95%置信区间3.19 - 6.04）、肺空洞（比值比2.62，95%置信区间1.85 - 3.71）及更多症状（比值比1.81，95%置信区间1.20 - 2.73）相关。
DM与更长的诊断延误相关，而诊断延误又与更严重的肺结核临床表现相关。因此，有必要研究合并和未合并DM的肺结核患者中与诊断延误相关的危险因素。
