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肺结核伴和不伴 2 型糖尿病的临床放射学特征及治疗转归。

Clinico-radiological profile and treatment outcome of pulmonary tuberculosis with and without type 2 diabetes mellitus.

机构信息

Department of Respiratory Medicine, Government General & Chest Hospital, Osmania Medical College, Hyderabad, India.

Mallareddy Institute of Medical Sciences, Hyderabad, India.

出版信息

Indian J Tuberc. 2021 Apr;68(2):249-254. doi: 10.1016/j.ijtb.2020.09.020. Epub 2020 Sep 28.

Abstract

BACKGROUND

The bidirectional association between tuberculosis (TB) and diabetes mellitus (DM) is currently one of the major concerns for clinicians, as DM affects the disease presentation and clinical outcome of TB and vice versa. The interest in diabetes mellitus and tuberculosis is mounting rapidly and it promises to be an exciting time for researchers involved in the study of dual diseases.

METHODS

A prospective case control study was conducted over a period of one year, on patients diagnosed with pulmonary tuberculosis (PTB) with and without associated type 2 diabetes mellitus, who were admitted in a tertiary care hospital. Pulmonary TB patients with diabetes were labelled as the case group, and those without diabetes were labelled as the control group. A total number of 63 patients in the case group were compared with 63 patients in the control group.

RESULTS

In the present study, clinical symptoms were similar in both the case and control groups, except for haemoptysis (27% vs. 12.7%) and weight loss (96.8% vs. 84.1%), which were significantly more predominant in the case group. There was a significant radiological involvement of the lower lung fields (46% vs. 17.5%) with cavitations (42.9% vs. 20.6%) in the case versus the control group. The sputum conversion at the end of the 2nd month was 92.1% in the control group and 55.6% in the case group (p = 0.001). In addition, cure rate in the control group was notably higher than in the case group (81% vs. 61.9%). The proportion of treatment failures were more among the case group (14.3%) as compared to the control group (1.6%).

CONCLUSION

The present study concludes that, diabetes certainly affects the clinical, bacteriological and radiological presentation and treatment outcome of pulmonary tuberculosis.

摘要

背景

结核病(TB)和糖尿病(DM)之间的双向关联是目前临床医生关注的主要问题之一,因为 DM 会影响 TB 的疾病表现和临床结局,反之亦然。人们对糖尿病和结核病的兴趣正在迅速增加,这对于参与双重疾病研究的研究人员来说将是一个令人兴奋的时期。

方法

一项为期一年的前瞻性病例对照研究在一家三级保健医院对诊断为肺结核(PTB)且伴有或不伴有 2 型糖尿病的患者进行。患有糖尿病的肺结核患者被标记为病例组,没有糖尿病的患者被标记为对照组。病例组共有 63 名患者,对照组有 63 名患者。

结果

在本研究中,除咯血(27%比 12.7%)和体重减轻(96.8%比 84.1%)外,两组的临床症状相似,这些症状在病例组中更为明显。病例组的下肺野有明显的放射学受累(46%比 17.5%),有空洞形成(42.9%比 20.6%)。对照组在第 2 个月末痰培养转阴率为 92.1%,而病例组为 55.6%(p=0.001)。此外,对照组的治愈率明显高于病例组(81%比 61.9%)。与对照组(1.6%)相比,病例组的治疗失败比例更高(14.3%)。

结论

本研究表明,糖尿病肯定会影响肺结核的临床、细菌学和放射学表现以及治疗结局。

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