《结核病与糖尿病共病的治疗管理专家共识》解读

doi:10.3969/j.issn.1000-6621.2021.04.004

摘要/Abstract

摘要：

结核病与糖尿病共病的治疗管理一直是临床上的棘手问题,需要结核科与内分泌科医生共同制定治疗方案,共同进行随访管理,才能进一步提高其治愈率和降低死亡率。发表于《中国防痨杂志》2021年第1期的《结核病与糖尿病共病的治疗管理专家共识》就结核病与糖尿病共病治疗管理的常见问题提出了具体处理建议。笔者主要对共识中的共病概念、共病时糖尿病的治疗管理、相关药品不良反应的处理及注意事项等方面作进一步解读,以供中国从事结核病和糖尿病的临床工作者借鉴和参考。

关键词: 结核, 糖尿病, 共病现象, 诊疗工作管理,医学, 药物疗法,联合, 总结性报告(主题), 评论,基于问题的学习

Abstract:

The comorbidity of tuberculosis (TB) and diabetes (DM) is becoming a big clinical challenge. It requires physicians from TB and DM teams to work together to decide treatment plans and conduct follow-up management in order to further increase cure rate and reduce mortality. The Expert consensus on treatment and management of tuberculosis-diabetes mellitus comorbidity was published on the first issue of 2021 in the Chinese Journal of Antituberculosis. This consensus offered management recommendations for frequently met problems during the treatment of TB-DM. We hereby further interpret the concept of TB-DM comorbidity, the management of diabetes, adverse drug reactions and precautions during treatment for clinicians in our country when taking care of patients with TB-DM.

Key words: Tuberculosis, Diabetes mellitus, Combined modality therapy, Practice management, medical, Drug therapy, combination, Consensus development conferences as topic, Comment, problembased learning

邓国防. 《结核病与糖尿病共病的治疗管理专家共识》解读[J]. 中国防痨杂志, 2021, 43(4): 318-321. doi: 10.3969/j.issn.1000-6621.2021.04.004

DENG Guo-fang. Interpretation of Expert consensus on treatment and management of tuberculosis-diabetes mellitus comorbidity[J]. Chinese Journal of Antituberculosis, 2021, 43(4): 318-321. doi: 10.3969/j.issn.1000-6621.2021.04.004

图/表 2

参考文献 17

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临床类别	血糖控制目标
结核病治疗期间^{[6, 12]}
年龄较轻、病程较短、预期寿命较长、无并发症、未并发心血管疾病	HbA1c<7.0%,空腹<7.0mmol/L,非空腹<10.0mmol/L
并发心脑血管疾病、心脑血管疾病高风险、高龄、结核病病情严重	HbA1c<8.0%,空腹7.8~10.0mmol/L,非空腹 7.8~13.9mmol/L
非结核病治疗期间^[12,13]
年龄较轻、病程较短、预期寿命较长、无并发症、未并发心血管疾病	HbA1c<6.5%,空腹4.4~6.1mmol/L,非空腹 6.1~7.8mmol/L
大多数非妊娠成年2型糖尿病患者	HbA1c<7.0%,空腹 4.4~7.0mmol/L,非空腹<10.0mmol/L
高龄、低血糖发生风险较高且无法耐受低血糖、存在多器官功能不全、预期生存期低于5年、需重症监护	HbA1c<8.0%,空腹7.8~10.0mmol/L,非空腹 7.8~13.9mmol/L