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背景:糖尿病肺结核患者产生异常X线影像的比较性研究。 目的:对大量糖尿病肺结核患者的X线影像进行评价。 设计:复习住院的糖尿病肺结核患者(TBDM组,n=192)的X线片,与对照组单纯肺结核病患者(TB组,n=130)进行比较。 结果:两组的结核病演变时间相似(～2年)。所观察到的统计学差异如下:TBDM组病人年龄较高(为51.3±0.9岁,TB组为44.9±1.8岁,均数±均数标准误),上肺野发生率降低(17％比56％),下肺野病变发生率(19％比7％)及上肺野加下肺野病变率之和(82％比59％)升高。TBMD组发生空洞的病人多(82％比59％),并且多发生于下肺野(29％比3％)。多发空洞常见于TBDM组病人(25％比2％)。TBDM组病人白细胞总数偏低(8836.7±219.5比10013.1±345.2/mm~3),主要由于非淋巴细胞的白细胞数低(6815.8±221.8比8095.7±321.9/mm~3)。多元logistic回归分析显示,糖尿病是造成下肺野病灶和空洞最重要的因素。 结论:本研究以大量糖尿病肺结核患者资料证实这些病人的胸部X线影像与典型的表现显著不同。临床医生必须牢记这点以避免误诊。
Background: A comparative study of abnormal X-ray images in patients with diabetic pulmonary tuberculosis. Objective: To evaluate the X-ray images of a large number of diabetic patients with pulmonary tuberculosis. DESIGN: X-ray films of hospitalized patients with pulmonary tuberculosis (TBDM, n = 192) were reviewed and compared with those of patients with pulmonary tuberculosis (TB group, n = 130) in the control group. Results: The TB evolution time was similar in both groups (~ 2 years). The observed statistical differences were as follows: Patients in the TBDM group were older (51.3 ± 0.9 years; TB group was 44.9 ± 1.8 years, mean ± SD), and the incidence of upper lung fields was lower (17% vs 56 %), The incidence of lower field lesions (19% vs 7%) and the sum of lung field plus lower field lesions (82% vs. 59%). Patients in the TBMD group were mostly empty (82% vs. 59%) and mostly in the lower lung field (29% vs. 3%). Multiple cavities common in patients with TBDM (25% to 2%). The total number of leukocytes in patients with TBDM was lower (8836.7 ± 219.5 vs. 10013.1 ± 345.2 / mm 3), mainly due to a lower number of leukocytes (6815.8 ± 221.8 vs 8095.7 ± 321.9 / mm 3) in non-lymphocytes. Multivariate logistic regression analysis showed that diabetes was the most important factor contributing to lower lung field lesions and voids. CONCLUSIONS: In this study, a large number of patients with diabetes mellitus were shown to have significantly different chest X-ray images from those of typical patients. Clinicians must keep this in mind to avoid misdiagnosis.