Shi Cuilin, Shen Xinghua, Liu Jing, Huang Lijun, Ni Huanglei, Tang Peijun, Feng Yanjun, Wu Meiying, Zhang Jianping
The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, 215000, People's Republic of China.
Infect Drug Resist. 2025 May 8;18:2415-2425. doi: 10.2147/IDR.S490491. eCollection 2025.
To explore the influence of type 2 diabetes mellitus (T2DM) on the clinical outcomes of pulmonary tuberculosis (TB) and the factors that may affect outcomes. In addition, the treatment regimens of active pulmonary TB patients with or without T2DM were described.
This is a retrospective, single-center, real-world study conducted in the Fifth People's Hospital of Suzhou (China), an urban hospital. This study divided 340 inpatients with active TB who received standard anti-tuberculosis treatment into the T2DM and control groups, with 61 patients in the T2DM group and 279 patients in the control group. The outcomes were the time to negative sputum conversion and the rate of negative sputum conversion for tuberculosis bacteria at 2 months.
The percentage of patients who received the isoniazid, rifampin, pyrazinamide, and ethambutol (HRZE) regimen was numerically lower in the T2DM vs control group (73.8% vs 79.6%), while the use of the isoniazid, rifapentine, ethambutol, and levofloxacin (HRftELfx) regimen was numerically higher (14.8% vs 9.7%). The median time to negative sputum conversion was longer in the T2DM group (median, 60.00 vs 52.00 days, P<0.001). The rates of negative sputum conversion at 2 months were 85.2% vs 92.8% in the T2DM and control groups (P=0.055). The multivariable Cox regression analysis showed that the male sex (adjusted HR=0.759, 95% CI: 0.585-0.984, P=0.037) and T2DM (adjusted HR=0.721, 95% CI: 0.528-0.986, P=0.040) were independently associated with the time to negative sputum conversion.
Patients with TB and T2DM had a longer time to negative sputum conversion. In addition, being male significantly increased the risk of prolonged time to negative sputum conversion.
探讨2型糖尿病（T2DM）对肺结核（TB）临床结局的影响以及可能影响结局的因素。此外，还描述了合并或未合并T2DM的活动性肺结核患者的治疗方案。
这是一项在苏州市第五人民医院（中国）进行的回顾性、单中心、真实世界研究，该医院为一家城市医院。本研究将340例接受标准抗结核治疗的活动性肺结核住院患者分为T2DM组和对照组，T2DM组61例，对照组279例。结局指标为痰菌转阴时间和2个月时结核菌痰菌转阴率。
T2DM组接受异烟肼、利福平、吡嗪酰胺和乙胺丁醇（HRZE）方案治疗的患者比例在数值上低于对照组（73.8%对79.6%），而使用异烟肼、利福喷汀、乙胺丁醇和左氧氟沙星（HRftELfx）方案的比例在数值上更高（14.8%对9.7%）。T2DM组痰菌转阴的中位时间更长（中位数，60.00天对52.00天，P<0.001）。T2DM组和对照组2个月时的痰菌转阴率分别为85.2%和92.8%（P=0.055）。多变量Cox回归分析显示，男性（校正风险比[HR]=0.759，95%置信区间[CI]：0.585-0.984，P=0.037）和T2DM（校正HR=0.721，95%CI：0.528-0.986，P=0.040）与痰菌转阴时间独立相关。
合并T2DM的肺结核患者痰菌转阴时间更长。此外，男性显著增加了痰菌转阴时间延长的风险。
