2型糖尿病合并初治涂阳肺结核患者痰菌阴转情况及其危险因素分析

发布时间：2018-06-21 23:05

本文选题：型糖尿病 + 肺结核　；参考：《广东医学》2015年04期

【摘要】：目的分析2型糖尿病合并初治涂阳肺结核患者痰菌阴转情况及其影响因素。方法对住院治疗的2型糖尿病并初治涂阳的肺结核患者107例,统一予以2~3HRZE/9~10HR方案抗结核治疗,随访6个月以上,分析痰菌2个月末和6个月末的阴转情况,同时采用logistic向后逐步删除法多因素回归分析影响痰菌阴转的危险因素。结果治疗2个月末67.3%的患者痰菌阴转;6个月末89.7%的患者痰菌阴转。logistic多因素分析显示2个月末痰菌未阴转的危险因素为糖尿病病程长(OR=2.524,P=0.013)、病灶范围广(OR=1.136,P=0.000)、空洞多(OR=2.869,P=0.010)、治疗前高水平的糖化血红蛋白(OR=1.375,P=0.003)、治疗2月末高水平糖化血红蛋白(OR=2.795,P=0.007)、治疗2个月末高水平的空腹血糖(OR=2.493,P=0.023);6个月末痰菌未阴转的危险因素是病灶范围广(OR=1.186,P=0.034)、空洞多(OR=2.488,P=0.039)、2个月末痰菌阳性(OR=4.250,P=0.030)。结论 2型糖尿病合并初治涂阳肺结核的2个月末痰菌阴转率偏低,疾病的各宿主因素及血糖控制情况对2个月及6个月痰菌阴转存在不同影响。两病合并患者在治疗中需加强监测及管理。
[Abstract]:Objective to analyze the sputum negative transformation of type 2 diabetes mellitus with smear positive pulmonary tuberculosis and its influencing factors. Methods 107 cases of pulmonary tuberculosis with type 2 diabetes mellitus and initial smear positive were treated with 2HRZE / 9 10HR regimen. The patients were followed up for more than 6 months, and the negative changes of sputum bacteria at the end of 2 and 6 months were analyzed. At the same time, the risk factors of sputum negative transformation were analyzed by logistic step by step delete method. Results at the end of 2 months, 67.3% of the patients had sputum negative conversion, and 89.7% of the patients at the end of 6 months had sputum negative conversion. Logistic multivariate analysis showed that the risk factors of sputum negative transformation at the end of 2 months were the long course of diabetes mellitus (OR2. 524), wide foci (OR1. 136 P0. 000) and multiple cavity (OR2. 869P0. 010). The former high level of glycosylated hemoglobin (OR1. 375) was treated with high level of glycosylated hemoglobin (OR2. 795) at the end of February, and the high level of fasting blood glucose at the end of 2 months (OR2. 493, P0. 023). The risk factors of no negative transformation of sputum bacteria at the end of 6 months were extensive focus (OR1. 186 P0.034), multiple cavities (OR2. 488P0. 039), and two month end sputum bacteria positive (OR4. 250 P0. 030). Conclusion the sputum negative conversion rate of type 2 diabetes mellitus with smear positive pulmonary tuberculosis at the end of 2 months is low. The host factors and blood glucose control of the disease have different effects on sputum negative conversion at 2 and 6 months. Monitoring and management should be strengthened in the treatment of patients with two diseases.
【作者单位】：广东省广州市胸科医院内分泌合并结核病科;
【基金】：广州市医药卫生科技一般引导项目(编号:20131A011077) 广州市胸科医院立项管理项目(编号:2012-xk005)
【分类号】：R521;R587.1

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