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目的了解肺结核合并糖尿病(DM)的比例,为制定结核病化疗方案提供参考依据。方法采用美国DMENSIONAR全自动生化分析仪葡萄糖氧化酶法,测定空腹外周静脉血浆葡萄糖(FVPG)和2 h外周静脉血浆葡萄糖(2hPG)。结果监测946例初治肺结核,检出糖尿病(DM)和空腹血糖调节受损(IFG)83例,总检出率8.77%。检出糖尿病52例,检出率5.50%,各年间检出率差异无统计学意义(P=0.79)。检出空腹血糖调节受损31例,检出率3.28%,各年间检出率比较,差异无统计学意义(P=0.17)。涂阳肺结核中糖尿病检出率7.35%,涂阴肺结核糖尿病检出率4.25%,差异有统计学意义(P=0.03),45~74岁糖尿病检出率最高为10.26%~10.71%(P=0.001),家务、退休、干部和渔民糖尿病检出率较高,男女之间糖尿病检出率差异无统计学意义(P=0.25)。结论肺结核合并糖尿病者占有一定比例,在制定化疗方案时,应注意糖尿病并发症和药物毒性反应,疗程宜9~12个月。
Objective To understand the proportion of pulmonary tuberculosis with diabetes mellitus (DM), to provide a reference for the development of tuberculosis chemotherapy. Methods Fasting peripheral venous plasma glucose (FVPG) and peripheral venous plasma glucose (2hPG) were measured by glucose oxidase method using DMENSIONAR automatic biochemical analyzer. Results A total of 946 cases of newly diagnosed pulmonary tuberculosis (TB) were detected. Diabetes mellitus (DM) and impaired fasting glucose (IFG) were detected in 83 cases with a total detection rate of 8.77%. Diabetes was detected in 52 cases, the detection rate was 5.50%, the detection rate of each year was no significant difference (P = 0.79). 31 patients with impaired fasting glucose were detected, the detection rate was 3.28%. There was no significant difference in detection rate between years (P = 0.17). The detection rate of diabetes in smear positive pulmonary tuberculosis was 7.35%, and that of smear negative pulmonary tuberculosis was 4.25% (P = 0.03). The highest prevalence of diabetes in 45-74 years old was 10.26% -10.71% (P = 0.001). There was a higher detection rate of diabetes in housework, retirement, cadres and fishermen. There was no significant difference in the detection rate of diabetes between men and women (P = 0.25). Conclusions Pulmonary tuberculosis with diabetes accounts for a certain proportion. When formulating chemotherapy regimens, attention should be paid to complications of diabetes and drug toxicity. The course of treatment should be 9 to 12 months.