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目的探讨肺结核合并糖尿病的临床体征、肺部特征、影像学检查特征、实验室检查情况。方法选取本院2008年1月至2012年12月收治的肺结核合并糖尿病患者56例,对这些患者的临床诊断、检查资料进行回顾性总结分析。结果本组56例患者肺结核的临床症状表现为咳嗽30例(53.57%),发烧16例(28.57%),胸部疼痛20例(35.71%),咯血10例(17.86%),四肢乏力16例(28.57%),胸腔积液8例(14.29%),没有明显症状14例(25%);本组患者临床肺部体征表现为呼吸音减弱11例(19.64%),湿罗音18例(32.14%),没有肺部体征27例(48.21%);胸部DR影像学检查表现存在肺叶或段状分布的实质性病变或者肺不张特征40例(71.43%),结节或者肿块样病变15例(26.79%),不典型空洞21例(37.5%),弥漫性粟粒结节3例(5.36%);实验室检查表现白细胞升高24例(25%),白细胞减少4例(7.14%),血沉增快48例(85.71%),结核菌素试验强阳性38例(67.86%)。结论对于肺结核合并糖尿病病例的临床诊断应进行相关检查并结合患者的临床体征进行综合判断。
Objective To investigate the clinical signs, pulmonary features, imaging features and laboratory conditions of pulmonary tuberculosis complicated with diabetes. Methods Fifty-six patients with pulmonary tuberculosis complicated with diabetes treated in our hospital from January 2008 to December 2012 were retrospectively reviewed. The clinical diagnosis and examination data of these patients were retrospectively analyzed. Results The clinical manifestations of pulmonary tuberculosis in this group of patients were as follows: cough 30 cases (53.57%), fever 16 cases (28.57%), chest pain 20 cases (35.71%), hemoptysis 10 cases (17.86%), limb weakness 16 cases 28.57%), pleural effusion in 8 cases (14.29%) and no obvious symptoms in 14 cases (25%). The clinical signs of lung in this group were as follows: decreased breath sounds in 11 cases (19.64%), wet rales in 18 cases %). There were no pulmonary signs in 27 cases (48.21%). Thoracic DR imaging showed that there were 40 lesions (71.43%) of pulmonary lesion or segmental distribution or 15 cases of nodules or mass-like lesions (26.79%), atypical cavity in 21 cases (37.5%) and diffuse miliary nodules in 3 cases (5.36%). Laboratory tests showed leukopenia in 24 cases (25%) and leucopenia in 4 cases (7.14% Echinococcosis increased in 48 cases (85.71%), tuberculin test strongly positive in 38 cases (67.86%). Conclusion The clinical diagnosis of pulmonary tuberculosis complicated with diabetes should be related to the examination and combined with the clinical signs of patients to make a comprehensive judgment.