肺结核合并糖尿病患者临床特征及营养状况调查分析

发布时间：2018-03-06 19:58

本文选题：肺结核　切入点：糖尿病　出处：《青岛大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的肺结核合并糖尿病(PTB-DM)患者在临床表现及机体状况等方面有别于单纯肺结核患者。本文旨在通过了解肺结核合并糖尿病患者的临床特征与营养状况,为其临床诊疗与营养支持提供具有针对性的建议。方法选取某市胸科医院2011年12月至2012年8月间住院的116例肺结核合并糖尿病患者为PTB-DM组,另选取该院同期住院的136例单纯肺结核(PTB)患者为PTB组,比较两组入院时临床症状的发生率、血沉(ESR)加快率、痰涂片阳性率、空洞发生率和营养状况相关指标如总胆固醇(TC)、甘油三酯(TG)、体质指数(BMI)、血红蛋白(Hb)、血清白蛋白(ALB)及淋巴细胞计数(TLC)。结果在呼吸道症状方面,PTB-DM组患者咳嗽、咳痰与咯血的发生率分别为97.4%、90.5%和31.0%,高于PTB组的88.2%、80.9%和14.0%,差异有统计学意义(P0.05)；在全身症状方面,PTB-DM组患者乏力和食欲减退的发生率分别为68.1%和40.0%,高于PTB组的55.1%和27.9%,差异有统计学意义(P0.05)；ESR加快的检出率,PTB-DM组与PTB组分别为81.9%和66.9%,PTB-DM组明显升高(P0.05)；PTB-DM组患者痰涂片阳性的检出率为78.4%,高于PTB组的66.2%,差异有统计学意义(P0.05)；PTB-DM组患者病灶所在肺野数多于2个的患者所占比例为61.20%,而PTB组为53.7%,差异无统计学意义(P0.05)。PTB-DM组空洞形成率为63.8%,高于PTB组的39.7%,差异有统计学意义(P0.05)。营养状况分析显示,TC和TG水平PTB-DM组分别为4.39mmol/L和1.43mmol/L,PTB组分别为3.97mmol/L和1. Olmmol/L,两组间差异有统计学意义(P0.05)；PTB-DM组的TLC为1.36×109/L,明显低于PTB组的1.52×109/L(P0.05)；PTB-DM组与PTB组的BMI分别为21.60kg/m2和21.10kg/m2,Hb分别为126.62g/L和129.93g/L,ALB分别为39.23g/L和39.08g/L,两组间差异均无统计学意义(P0.05)；高胆固醇血症、高甘油三脂血症和TLC减少的发生率PTB-DM组分别为19.8%、28.4%和61.2%,均高于PTB组的8.8%、5.1%和45.6%,差异有统计学意义(P0.05),消瘦、贫血和低白蛋白血症的发生率PTB-DM分别为16.4%、35.3%和24.1%,PTB组分别为19.1%、25.7%和21.3%,两组间的差异无统计学意义(P0.05)。结论与PTB患者相比,PTB-DM患者的病情相对较重,高胆固醇血症和高甘油三脂血症的发生率增高,临床上应给予具有针对性的诊疗措施及饮食指导。
[Abstract]:Objective to study the clinical features and nutritional status of patients with pulmonary tuberculosis complicated with diabetes mellitus (PTB-DM). To provide targeted advice for its clinical diagnosis and treatment and nutrition support. Methods A total of 116 pulmonary tuberculosis patients with diabetes mellitus were selected as PTB-DM group from December 2011 to August 2012, and 136 patients with simple pulmonary tuberculosis were selected as PTB group. The incidence of clinical symptoms, the accelerated rate of ESR and the positive rate of sputum smear were compared between the two groups. The incidence of cavities and nutritional status such as total cholesterol TCX, triglyceride TGN, body mass index (BMI), hemoglobin (HB), serum albumin (ALB) and lymphocyte count (TLC) were measured. Results in terms of respiratory symptoms, the patients in PTB-DM group had cough. The incidences of expectoration and hemoptysis were 90.5% and 31.0%, respectively, which were higher than those in PTB group (88.20.9% and 14.0%, respectively), the difference was statistically significant (P 0.05), the incidence of fatigue and anorexia in PTB-DM group was 68.1% and 40.0% respectively, which was higher than that in PTB group (55.1% and 27.9). The positive rate of sputum smear in PTB-DM group and PTB group was 81.9% and 66.9 respectively. The positive rate of sputum smear in PTB-DM group was 78.4%, which was higher than that in PTB group (66.2%). The difference was statistically significant in the number of pulmonary fields in PTB-DM group. The proportion of patients in two groups was 61.20 and 53.7in PTB group. There was no significant difference in cavitation formation rate between P0.05 and PTB-DM groups, which was higher than that in PTB group (39.7%). The nutritional status analysis showed that TC and TG levels in PTB-DM group were 4.39 mmol / L and 1.43 mmol / L PTB respectively. The TLC of PTB-DM group was 1.36 脳 10 9 / L, which was significantly lower than that of PTB group (1.52 脳 10 9 / L P 0.05%) and BMI of PTB-DM group and PTB group were 21.60 kg / m ~ 2 and 21.10 kg 路m ~ (-2) h ~ (-1) respectively. The TLC of PTB-DM group was 39.23 g / L and 39.08 g / L, respectively, and the BMI of PTB group was 21.60 kg / m ~ (2) and 21.10 kg 路m ~ (-2) H _ b of PTB group, respectively. The difference between the two groups was 39.23 g / L and 39.08 g / L, respectively. There was no significant difference between the two groups in hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia and hypercholesterolemia. The incidence of hypertriglyceridemia and reduction of TLC in PTB-DM group was 28.4% and 61.2%, respectively, which was higher than that in PTB group (8.8% and 45.6%). The difference was statistically significant (P 0.05). The incidence of anemia and hypoalbuminemia in the PTB-DM group was 16.435. 3% and 24. 1%, respectively. The incidence of anemia and hypoalbuminemia in the PTB group was 19. 1% and 21. 3%, respectively. There was no significant difference between the two groups (P 0. 05). Conclusion compared with the patients with PTB, the patients with PTB-DM are more serious, the incidence of hypercholesterolemia and hypertriglyceridemia is higher.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R521;R587.1

【参考文献】