摘要
目的:总结和研究老年糖尿病合并肺结核的临床特点。方法:分析1981 ～1995 年间诊治的两病并发57 例患者的临床和实验室资料。结果:老年糖尿病合并肺结核患者除有常见的咳嗽、咳痰、发热、咯血等呼吸道症状外,常以食欲不振、消瘦、乏力、精神萎靡等为主诉而就诊,而糖尿病“三多”症状常少见;合并呼吸系统疾病和心脑血管疾病为多见,并发症以冠心病、白内障、糖尿病肾病为多见;X线胸片其双侧病变和慢性纤维空洞性改变较单纯肺结核者多见( 分别为56 .1% 和36.8 %) 。经治疗3 个月后,血糖被控制在正常范围者49 例,结核病变吸收和好转者41 例,痰菌阴转19 例,空洞闭合或缩小者13 例,空洞无变化5 例,死亡3 例。结论:两病并发较为常见,症状复杂而不典型,X 线表现多样,合并症多,易漏诊、误诊,病情重,治疗难,病死率高。
Objective:The purpose of the investigation was to summarize the clinical features of aged patients with diabetes mellitus complicated by pulmonary tuberculosis.Methods:The clinical and laboratory data from 57 cases during a period of 15 years were analyzed.Result:Apart from the common symptoms of respiratory tract,such as cough,expectoration,fever,hemoptysis etc.,anorexia,emaciation,fatigue and listless were usually turned to chief complaints which the patients make a medical visit for.By contrast,the polyuria and polydipsia of diabetes mellitus were rarely found in these patients.Complications in respiratory system and cardio-cerebral vessel occurred frequently,i.e.,coronary heart disease,cataract,diabetic nephropathy,etc.The X-ray film for chest showed that the bilateral lesion and chronic fibrous hollow alteration in lungs more often happened than simple pulmonary tuberculosis(56.1% vs 36.8%).After 3 months of treatment,the levels of blood sugar in 49 cases were controlled into normal range,the lesions of tuberculosis in 41 cases were absorbed and improved,the tubercle bacilli in sputum of 19 cases were turned to negative,the cavities in lungs of 13 cases were closed or reduced.No shift of the cavities was found in 5 cases and there were 3 deaths.Conclusion:Diabetes mellitus complicated by pulmonary tuberculosis is quite common.It's mortality is high because of atypical symptoms,various manifestations on X-ray film,diverse complications,misdiagnosis critical conditions and troublesome treatment.
出处
《南京铁道医学院学报》
1999年第4期272-274,共3页
Journal of Nanjing Railway Medical College
