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2 型糖尿病合并原发性肺结核患者 CT 特征与胰岛素抵抗水平的相关性。

The correlation between CT features and insulin resistance levels in patients with T2DM complicated with primary pulmonary tuberculosis.

机构信息

Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University/Affiliated Lishui Hospital of Zhejiang University/The Central Hospital of Zhejiang Lishui, Lishui, China.

Department of Medical Imaging, The Fourth People's Hospital of Huai'an, Huai'an, Jiangsu, China.

出版信息

J Cell Physiol. 2020 Dec;235(12):9370-9377. doi: 10.1002/jcp.29741. Epub 2020 Apr 28.

Abstract

The aim is to investigate the correlation between computed tomography (CT) features and insulin resistance levels in patients with type 2 diabetes mellitus (T2DM) complicated with primary pulmonary tuberculosis (PTB). Nearly, 268 untreated PTB patients complicated with T2DM were divided into two groups according to the optimal cutoff value of HOMA-IR score for the Chinese population: HOMA-IR ≤ 2.69 (Group I: 74 patients), >2.69 (Group II: 194 patients). The basic characteristics and changes of CT manifestations were analyzed. In the two groups, the detection rate of large segmented leafy shadow was 39.2% and 78.9%; the air bronchogram sign detection rate was 40.5% and 80.9%; the discovery rate of mouth-eaten cavity was 33.8% and 73.7%; the thin-walled cavity detection rate was 2.7% and 16.0%; the rate of multiple cavities was 35.1% and 69.6%; and bronchial tuberculosis was found in 4.1% and 35.6%, respectively. The detection rates of lesions in Group II were significantly higher than in Group I (p < .05). HOMA-IR was found independently associated with large segmented leafy shadow, air bronchial sign, thin-walled cavity, and bronchial tuberculosis. The level of insulin resistance can effectively reflect the severity of PTB patients with T2DM. CT scan can directly provide image information in clinics. These two examinations can guide clinicians to accurately formulate subsequent treatment plans.

摘要

目的

探讨 2 型糖尿病(T2DM)合并原发性肺结核(PTB)患者 CT 特征与胰岛素抵抗水平的相关性。将近 268 例未经治疗的合并 T2DM 的 PTB 患者根据 HOMA-IR 评分的中国人最佳截断值分为两组:HOMA-IR≤2.69(组 I:74 例)和>2.69(组 II:194 例)。分析了基本特征和 CT 表现变化。在两组中,大节段叶状阴影的检出率分别为 39.2%和 78.9%;空气支气管征的检出率分别为 40.5%和 80.9%;口蚀腔的检出率分别为 33.8%和 73.7%;薄壁腔的检出率分别为 2.7%和 16.0%;多发腔的检出率分别为 35.1%和 69.6%;支气管结核的检出率分别为 4.1%和 35.6%。组 II 中病变的检出率明显高于组 I(p<0.05)。HOMA-IR 与大节段叶状影、空气支气管征、薄壁腔和支气管结核独立相关。胰岛素抵抗水平可有效反映合并 T2DM 的 PTB 患者的严重程度。CT 扫描可在临床上提供直接的图像信息。这两种检查可以指导临床医生准确制定后续治疗计划。

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