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菌阳肺结核合并糖尿病的CT影像学表现及临床意义

Computed tomography imaging and clinical significance of bacterium-positive pulmonary tuberculosis complicated with diabetes.

作者信息

Rong Xue-Song, Yao Chao

机构信息

Section 6, Department of Tuberculosis, Anhui Chest Hospital, Hefei 230022, Anhui Province, China.

出版信息

World J Clin Cases. 2024 Jul 16;12(20):4230-4238. doi: 10.12998/wjcc.v12.i20.4230.

Abstract

BACKGROUND

The increasing prevalence of tuberculosis (TB) and diabetes on a global scale poses a significant health challenge, particularly due to their co-occurrence, which amplifies the severity, recurrence and mortality rates associated with both conditions. This highlights the need for further investigation into their inter-relationship.

AIM

To explore the computed tomography (CT) imaging and clinical significance of bacterium-positive pulmonary TB (PTB) combined with diabetes.

METHODS

There were 50 patients with bacterium-positive PTB and diabetes, and 50 with only bacterium-positive PTB. The latter were designated as the control group. The CT imaging of the two groups of patients was compared, including lesion range, shape, density and calcification.

RESULTS

No significant differences were observed in age, gender, smoking and drinking history, high blood pressure, hyperlipidemia and family genetic factors between the groups. However, compared to the patients diagnosed solely with simple bacterium-positive PTB, those with concurrent diabetes showed a wider range of lesions and more complex and diverse morphology on CT images. Among them, intrapulmonary tuberculosis lesions were often accompanied by manifestations of pulmonary infection, such as cavity formation and bronchiectasis. At the same time, diabetes-related signs were often seen on CT images, such as pulmonary infection combined with diabetic pulmonary lesions. Logistic regression analysis identified age and medical history as significant factors influencing the degree of pulmonary infection and CT imaging outcomes in patients with both TB and diabetes. This suggests that older age and specific medical histories may increase the risk or severity of pulmonary damage in these patients.

CONCLUSION

CT imaging reveals more complex lesions in PTB patients with diabetes, emphasizing the need for careful evaluation and comprehensive analysis to enhance diagnostic accuracy.

摘要

背景

结核病(TB)和糖尿病在全球范围内的患病率不断上升,构成了重大的健康挑战,尤其是它们的共同出现,加剧了与这两种疾病相关的严重程度、复发率和死亡率。这凸显了进一步研究它们之间相互关系的必要性。

目的

探讨细菌学阳性肺结核(PTB)合并糖尿病的计算机断层扫描(CT)影像学表现及临床意义。

方法

选取50例细菌学阳性的PTB合并糖尿病患者和50例仅细菌学阳性的PTB患者。后者被指定为对照组。比较两组患者的CT影像学表现,包括病变范围、形态、密度和钙化情况。

结果

两组患者在年龄、性别、吸烟和饮酒史、高血压、高脂血症及家族遗传因素方面未观察到显著差异。然而,与单纯诊断为细菌学阳性PTB的患者相比,合并糖尿病的患者在CT图像上显示出更广泛的病变范围和更复杂多样的形态。其中,肺结核病灶常伴有肺部感染表现,如空洞形成和支气管扩张。同时,CT图像上常可见糖尿病相关征象,如肺部感染合并糖尿病性肺部病变。Logistic回归分析确定年龄和病史是影响TB和糖尿病患者肺部感染程度及CT影像学结果的重要因素。这表明老年和特定病史可能增加这些患者肺部损伤的风险或严重程度。

结论

CT影像学显示糖尿病PTB患者的病变更为复杂,强调需要仔细评估和综合分析以提高诊断准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2693/11235566/a4072582bbab/WJCC-12-4230-g001.jpg

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