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中国上海老年人群中肺结核患者的糖尿病:患病率、临床特征及转归

Diabetes mellitus in patients with pulmonary tuberculosis in an aging population in Shanghai, China: Prevalence, clinical characteristics and outcomes.

作者信息

Wu Zheyuan, Guo Juntao, Huang Ying, Cai Enmao, Zhang Xia, Pan Qichao, Yuan Zheng'an, Shen Xin

机构信息

Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.

Shanghai Changning Center for Disease Control and Prevention, Shanghai, China.

出版信息

J Diabetes Complications. 2016 Mar;30(2):237-41. doi: 10.1016/j.jdiacomp.2015.11.014. Epub 2015 Dec 1.

Abstract

AIMS

To determine the prevalence of diabetes mellitus among pulmonary tuberculosis patients and the difference of clinical characteristics and outcomes between pulmonary tuberculosis patients with and without diabetes mellitus in an aging population in Shanghai, China.

METHODS

This is a retrospective population-based study. 201 newly diagnosed pulmonary tuberculosis patients in Changning District, Shanghai during 2007-2008 were included. Clinical characteristics and outcomes were collected. Determination of diabetes mellitus was based on the medical records before pulmonary tuberculosis was diagnosed.

RESULTS

The prevalence of diabetes mellitus among pulmonary tuberculosis patients was 19.9% (40/201). Pulmonary tuberculosis patients with diabetes mellitus were more likely to be old (≥50, OR=5.23, 95% CI=2.07-13.25), to have pulmonary cavities (OR=3.02, 95% CI=1.31-6.98), to be sputum smear positive (OR=2.90, 95% CI=1.12-7.51), and to have extension of anti-tuberculosis treatment duration (OR=2.68, 95% CI 1.17-6.14). Besides, they had a higher 2nd month sputum smear positive proportion (OR=2.97, 95% CI 1.22-7.22) and a higher 5-year recurrence rate (OR=5.87, 95% CI 1.26-27.40).

CONCLUSIONS

High prevalence, severe clinical characteristics and poor outcomes of pulmonary tuberculosis patients with diabetes mellitus highlight the necessity of early bi-directional screening and co-management of these two diseases in Shanghai, China.

摘要

目的

在中国上海的老年人群中,确定肺结核患者中糖尿病的患病率,以及合并糖尿病和未合并糖尿病的肺结核患者临床特征和结局的差异。

方法

这是一项基于人群的回顾性研究。纳入了2007年至2008年期间上海市长宁区201例新诊断的肺结核患者。收集临床特征和结局。糖尿病的诊断基于肺结核诊断前的病历记录。

结果

肺结核患者中糖尿病的患病率为19.9%(40/201)。合并糖尿病的肺结核患者更有可能年龄较大(≥50岁,比值比=5.23,95%置信区间=2.07-13.25),有肺空洞(比值比=3.02,95%置信区间=1.31-6.98),痰涂片阳性(比值比=2.90,95%置信区间=1.12-7.51),以及抗结核治疗疗程延长(比值比=2.68,95%置信区间1.17-6.14)。此外,他们第二个月痰涂片阳性比例更高(比值比=2.97,95%置信区间1.22-7.22),5年复发率更高(比值比=5.87,95%置信区间1.26-27.40)。

结论

合并糖尿病的肺结核患者患病率高、临床特征严重且结局不佳,凸显了在中国上海对这两种疾病进行早期双向筛查和联合管理的必要性。

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