Smurova T F, Egorova I L
Klin Med (Mosk). 1993;71(3):58-62.
The performance of the insular system of the pancreatic gland was studied in 111 pulmonary tuberculosis patients who suffered from diabetes mellitus as were the functions of thyroid and pituitary-adrenal glands assessed by the blood content of C-peptide, T3, T4, TTH, ACTH and circadian excretion of 17-OCS. It was stated that the combined pathology was accompanied with pronounced endocrine disorders, pancreatic incretory function was found to be depended both on the pattern and severity of diabetes mellitus course and clinical manifestations of pulmonary tuberculosis. In combined disease high frequency of absolute and relative insufficiency of hypophyseal adrenocortical performance and adrenal glucocorticoid performance occurs. Revealed disorders were found to be depended on the clinical patterns of pulmonary tuberculosis and the type of diabetes mellitus as well as on the duration and severity of the course of both conditions. Combined pathology was frequently (60%) accompanied with the development of hypothyrosis manifested by the reduction of T3 content in the blood serum, imbalance of thyroid hormones (elevation of T4 to T3 ratio). The disorders mentioned were mostly manifest in patients with severe course of the combined pathology. Hypothyrosis aggravated a therapeutic prognosis for tuberculosis in diabetic patients. The treatment of both conditions performed with regard to the character of endocrine disorders was of great aid in reaching the improvement in the course of pulmonary tuberculosis in 92.8%.
对111例患有糖尿病的肺结核患者的胰岛系统功能进行了研究，并通过C肽、T3、T4、促甲状腺激素（TTH）、促肾上腺皮质激素（ACTH）的血含量以及17-氧皮质类固醇（17-OCS）的昼夜排泄量来评估甲状腺和垂体-肾上腺的功能。结果表明，合并病变伴有明显的内分泌紊乱，发现胰腺分泌功能既取决于糖尿病病程的类型和严重程度，也取决于肺结核的临床表现。在合并疾病中，垂体肾上腺皮质功能和肾上腺糖皮质激素功能出现绝对和相对不足的频率较高。所发现的紊乱取决于肺结核的临床类型、糖尿病的类型以及两种疾病病程的持续时间和严重程度。合并病变经常（60%）伴有甲状腺功能减退的发生，表现为血清中T3含量降低、甲状腺激素失衡（T4与T3比值升高）。上述紊乱大多在合并病变严重病程的患者中表现出来。甲状腺功能减退加重了糖尿病患者肺结核的治疗预后。针对内分泌紊乱的特点对两种疾病进行治疗，对92.8%的肺结核病程改善有很大帮助。
