Xia Li-Li, Li Su-Fen, Shao Kan, Zhang Xin, Huang Shan
Department of Endocrinology, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Neurology, Huai'an Second People's Hospital and The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, People's Republic of China.
Infect Drug Resist. 2018 Jan 30;11:187-193. doi: 10.2147/IDR.S146741. eCollection 2018.
To investigate the correlation between computed tomography (CT) features and glycosylated hemoglobin (HbAlc) levels in patients with type 2 diabetes mellitus (T2DM) complicated with primary pulmonary tuberculosis (PTB). One hundred and eighty untreated PTB patients complicated with T2DM were selected. Based on the HbAlc level, the patients were divided into three groups: HbAlc level <7% (Group I: 32 patients), 7%-9% (Group II: 48 patients), and >9% (Group III: 100 patients). The changes of CT manifestations and HbAlc were analyzed after TB and T2DM treatment. In the three groups, the detection rate of large segmented leafy shadow was 50%, 56.2%, and 87%; the air bronchogram sign detection rate was 40.6%, 47.9%, and 77%; the discovery rate of mouth-eaten cavity was 31.2%, 45.8%, and 65%; thick wall cavity detection rate was 25%, 31.2%, and 52%; the rate of multiple cavities was 34.3%, 50%, and 73%; and bronchial TB was found in 33.3%, 21.8%, and 46%, respectively. The detection rates of lesions in Group III were significantly higher than in Group II and Group I (<0.05), and this increase was significant (<0.05). After treatment, the HbAlc level reached control target (<7%) among all three groups and CT absorption improvement rates were 100%, 72.9%, and 56% respectively. The therapeutic efficacy of group I was better than group II (<0.01), and the treatment efficacy of group II was better than group III (<0.05). CT manifestations of T2DM complicated with PTB were closely related to HbAlc level. The effect is better when HbAlc level <7%. HbAlc level effectively reflects the severity and therapeutic effect to a certain extent. CT scan can provide some important information for clinical imaging. The above two examinations can guide clinicians to formulate the appropriate diagnosis and treatment in a timely manner.
探讨2型糖尿病（T2DM）合并原发性肺结核（PTB）患者的计算机断层扫描（CT）特征与糖化血红蛋白（HbAlc）水平之间的相关性。选取180例未经治疗的PTB合并T2DM患者。根据HbAlc水平，将患者分为三组：HbAlc水平<7%（I组：32例患者）、7%-9%（II组：48例患者）和>9%（III组：100例患者）。分析结核病和T2DM治疗后CT表现及HbAlc的变化。三组中，大片状叶状阴影检出率分别为50%、56.2%和87%；空气支气管征检出率分别为40.6%、47.9%和77%；虫蚀样空洞发现率分别为31.2%、45.8%和65%；厚壁空洞检出率分别为25%、31.2%和52%；多发空洞率分别为34.3%、50%和73%；支气管结核检出率分别为33.3%、21.8%和46%。III组病变检出率显著高于II组和I组（<0.05），且这种升高具有显著性（<0.05）。治疗后，三组患者的HbAlc水平均达到控制目标（<7%），CT吸收改善率分别为100%、72.9%和56%。I组治疗效果优于II组（<0.01），II组治疗效果优于III组（<0.05）。T2DM合并PTB的CT表现与HbAlc水平密切相关。当HbAlc水平<7%时效果较好。HbAlc水平在一定程度上有效反映病情严重程度及治疗效果。CT扫描可为临床影像提供一些重要信息。上述两项检查可指导临床医生及时制定合适的诊断和治疗方案。
