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目的分析南京市胸科医院住院肺结核合并糖尿病(PTB-DM)患者的流行病学特征,为改善预后、疫情防控提供参考。方法纳入2013年8月至2014年7月在南京市胸科医院结核科住院治疗的194例确诊PTB-DM患者,同期住院单纯肺结核患者1 262例作为对照。采用率和构成比描述肺结核患者中糖尿病患病率及临床特点,探讨其可能相关影响因素。结果住院肺结核患者糖尿病患病率为13.32%;PTB-DM患者平均年龄50岁,以农民居多,经济收入较低,受教育程度差,离异或丧偶比例高,多数存在吸烟嗜好;PTB-DM患者临床症状突出,血糖控制差,痰结核分枝杆菌阳性率(70.62%)、肺部空洞率(72.16%)、不良转归率(12.22%)均显著高于单纯肺结核患者(χ~2分别为55.143、49.124、8.99,P均<0.05)。结论住院肺结核患者糖尿病患病率高、临床症状重,应重视相关危险因素,加强大规模双向筛查工作,这对改善预后、减少传染源、控制结核病疫情等具有重大意义。
Objective To analyze the epidemiological characteristics of patients with pulmonary tuberculosis complicated with diabetes mellitus (PTB-DM) in Nanjing Chest Hospital and to provide reference for the prevention and control of the outbreak. Methods One hundred and ninety-four patients with PTB-DM were enrolled in the Department of Tuberculosis and Tuberculosis, Nanjing Chest Hospital between August 2013 and July 2014. A total of 1 262 cases of tuberculosis in hospital were enrolled in this study. Utilization rate and composition ratio to describe the prevalence of diabetes in patients with tuberculosis and clinical features to explore its possible related factors. Results The prevalence of diabetes in hospitalized patients with tuberculosis was 13.32%. The average age of PTB-DM patients was 50 years old. Most of the patients with PTB-DM had low incomes, poor education, high rates of divorced or widowed, and most of them had smoking habits. PTB-DM patients The clinical symptoms were prominent, the blood glucose control was poor, the positive rate of sputum Mycobacterium tuberculosis (70.62%), the pulmonary cavity rate (72.16%) and the unfavorable prognosis rate (12.22%) were significantly higher than those of patients with simple pulmonary tuberculosis 55.143,49.124,8.99, P <0.05). Conclusions Inpatients with pulmonary tuberculosis have a high prevalence of diabetes and severe clinical symptoms. Attention should be paid to related risk factors and large-scale bi-directional screening should be strengthened. This is of great significance in improving prognosis, reducing the source of infection and controlling the epidemic of tuberculosis.