摘要
糖尿病(diabetesmellitus,DM)流行对全球健康构成挑战,DM是结核病(tuberculosis,TB)的重要相关疾病之一。DM对TB产生较大影响,特别是可导致痰培养转阴延迟、增加TB治疗失败、复发和死亡率的风险。TB疫情依然严重,仍然在全球流行,其中一个重要原因可能是DM患者的增多,DM的流行可能影响WHO"终止TB策略",尤其TB合并DM患者防治形势雪上加霜。近年来越来越多的证据支持TB-DM的相互关系,这有助于更好理解贯彻TB-DM的综合防治的重要性。WHO提出到2035年终止结核病,提醒我们TB-DM的防治绝不可放松,否则结局仅是一个口号。本文综述了近年来全球TB与DM相互关系及其诊治新进展,提出了防治TB-DM新的双向筛查和早期诊治策略,包括加强TB患者DM监测,DM患者中TB的监测,DM患者中TB的抗结核治疗和TB患者中DM的降糖治疗及其管理,分别遵照DM和TB各领域制定的指南或国际标准进行。探索并切实贯彻"早发现、早报告、早诊断、早治疗、早隔离"的一体化、高效的TB合并DM有效的防控策略。
The growing epidemic of diabetes mellitus(DM) is set to become one of the major global health challenges. The rising DM epidemic could contribute to an increase in TB burden. DM also has a major effect on TB treatment outcomes; in particular,it is associated with delayed sputum culture conversion,increased risk of treatment failure,and increased risk of TB relapse and mortality. The tuberculosis epidemic is still serious and is still prevalent globally. One of the important reasons may be the rise of diabetes patients,and the prevalence of DM may affect WHO’s "End TB strategy",especially the prevention and treatment situation of patients with tuberculosis and diabetes.. With the accumulation of recent evidence supporting the TB–DM association,there is a need for an updated understanding of the magnitude of the TB–DM association. This understanding is critical for the implementation of comprehensive TB-DM control programs. The WHO’s proposal to end tuberculosis by 2035 reminds us that the prevention and treatment of tuberculosis and diabetes must not be relaxed,otherwise the "End TB"is just a slogan. This paper reviews the recent progress on the relationship between tuberculosis and diabetes and its diagnosis and treatment. A new bidirectional screening and early diagnosis and treatment strategy for the prevention and control of global TB-DM was put forward. These included strengthening the monitoring of tuberculosis in patients with diabetes,of diabetes in patients with tuberculosis,anti-tuberculosis treatment in patients with DM and hypoglycemic therapy and its management in TB patients with. The treatment were determined respectively according to the DM and TB guidelines or international standards. In the end,an effective and integrated strategy of prevention and control for twin-epidemic of DM-TB by early detection,early reporting,early diagnosis,early treatment and early isolation might be explored and implemented.
作者
杨松
严晓峰
YANG Song;YAN Xiao-feng(Department of Tuberculosis,Chongqing Public Health Medical Center,Chongqing 400036,China)
出处
《新发传染病电子杂志》
2018年第4期234-238,共5页
Electronic Journal of Emerging Infectious Diseases
基金
重庆市科学技术委员会技术创新与应用示范(社会民生类)资助(cstc2018jscx-msybX0062)
重庆市2018年科卫联合医学科研项目(面上项目)(2018MSXM021)
关键词
结核病
糖尿病
防治
策略
Tuberculosis
Diabetes mellitus
Preventionandtreatment
Strategy
