实用医学杂志 ›› 2022, Vol. 38 ›› Issue (16): 2061-2065.doi: 10.3969/j.issn.1006⁃5725.2022.16.015

• 临床研究 • 上一篇    下一篇

二甲双胍降糖治疗2型糖尿病合并肺结核的临床特点

汪敏1 邝浩斌1 袁园1 冯治宇1 蔡晓婷2 张宏1 吴迪1 陈泽莹1 黄显林1 谭守勇1    

  1. 1 呼吸疾病国家重点实验室,广州市胸科医院结核内科(广州510095); 2 广州市结核病防治所第二分所(广州510320)

  • 出版日期:2022-08-25 发布日期:2022-08-25
  • 通讯作者: 谭守勇 E⁃mail:tanshouyong@163.com
  • 基金资助:
    广州市高水平临床重点专科和培育专科建设项目(编号:穗卫函【2019】1555 号);广州市科技计划项目(编号:155700012)

The clinical characteristics of type 2 diabetes complicated with pulmonary tuberculosis during treatment with metformin

WANG Min*,KUANG Haobin,YUAN Yuan,FENG Zhiyu,CAI Xiaoting,ZHANG Hong,WU Di,CHEN Zeying,HUANG Xianlin,TAN Shouyong.    

  1. State Key Laboratory of Respiratory Disease,Department of Internal Medicine⁃Tuberculosis,Guangzhou Chest Hospital,Guangzhou 510095,China

  • Online:2022-08-25 Published:2022-08-25
  • Contact: TAN Shouyong E⁃mail:tanshouyong@163.com

摘要:

目的 探讨二甲双胍(MET)治疗的 2 型糖尿病(T2DM)患者在合并肺结核时(PTB)的临床 特点,为临床治疗策略提供参考。方法 收集 2013 1 月至 2018 1 月首次在本院住院治疗的 T2DM 并初治菌阳 PTB 患者临床资料。以 T2DM 患者在首次确诊 PTB 3 个月以上连续使用 MET 降糖治疗的为 观察组(MET 组)206 例,以同期在首次确诊 PTB 3 个月未使用 MET 治疗的为对照组(N⁃MET 组)749 例。 结果 MET 组和 N⁃MET HbA1c 达标率均较低(P = 0.703)。两组患者继发感染发生率差异无统计学意义 P = 0.703),MET 组患者中性粒细胞/淋巴细胞比值(NLR)、肺部病灶广泛程度及空洞发生均较 N⁃MET 低,差异有统计学意义(P = 0.021、0.045、0.039)。在 HbA1c < 7%患者合并肺部空洞发生较少(P < 0.001), MET 组病灶范围广泛程度较少(P = 0.042)。结论 MET 治疗 T2DM 患者合并 PTB 时,NLR 水平较低,病灶 范围及空洞发生较少。HbA1c < 7%的患者并发肺结核时病灶较少。

关键词:

二甲双胍, 2型糖尿病, 肺结核, 感染, 中性粒细胞/淋巴细胞比值

Abstract:

Objective To investigate the clinical characteristics of the pulmonary tuberculosis(PTB)with type 2 diabetes(T2DM)during treatment with metformin(MET)so as to provide reference for clinical treatment strategies. Methods The clinical data of 955 T2DM accompanied by primary PTB from January 2013 to January 2018 in our hospital were retrospectively analyzed. Of them,206 patients who had received the therapy with MET for more than three months before primary diagnosis with PTB were assigned into the observation group(MET group)and the rest 749 who had not received the therapy with MET for more than three months before primary diagnosis with PTB at the same period into the control group(NON⁃MET group). Results There were no statistical differences in the standard level of HbA1c < 7%(P = 0.703)between both the groups,and so it was with the secondary infection(P = 0.703). However,the NLR level,lung lesion range and rate of cavity occurrence in the MET group were all significantly lower or smaller than those in the non⁃MET group(P = 0.021,P = 0.045 and P = 0.039,respectively). The rate of cavity occurrence among the patients with HbA1c < 7% was lower(P < 0.001 and the lung lesion range in the MET group was smaller(P = 0.042). Conclusion T2DM patients with PTB treated with MET have a lower level of NLR,smaller range of lung lesions and lower rate of cavity occurrence. For those patients with HbA1c < 7%,the range of lung lesions is smaller.

Key words:

metformin, type 2 diabetes mellitus, pulmonary tuberculosis, infection, neutrophil? to?lymphocyte ratio