关键词: 结核,肺/流行病学, 糖尿病, 河南省

Abstract: Objective To study the epidemic status,clinical and X-ray radiographic manifestation,anti-TB drug resistance and treatment outcome of smearpositive pulmonary tuberculosis(SMPTB) with diabetes mellitus(DM) in Henan and provide evidence for clinical practice and public health practice. Methods This study was conducted together with the second antiTB drug resistance surveillance in Henan;Blood glucose test was taken in all SMPTB patients before anti-TB therapy(taking 75 grams of glucose orally and testing the level of blood sugar by drawing venous blood 2 hours later).Xray chest radiographs of the patients were read by the group consisting of TB specialists. Results Among the 902 SMPTB patients,12.6% patients were with DM and 14.9% patients were with impaired glucose tolerance(IGT),together accounting for 27.5%.The rates of DM and IGT among SMPTB patients aged at 40 or above were significantly higher than those among the SMPTB patients aged below 40(P<0.05).Anti-TB drug resistant rate among SMPTB patients with DM were 45.6%,which was significantly higher than that among SMPTB patients with normal level of blood glucose or IGT(35.2%,32.8%)(P<0.05).The frequency of lung lesions confined to mid or lower lung fields among SMPTB patients with DM or IGT was significantly higher than those among the SMPTB patients with normal level of blood glucose(P<0.05).The frequencies of effusive focus(93%),cheesy focus(87.7%) and pleural effusion(14.0%) were much higher among SMPTB with DM than those with normal level of blood glucose.The frequency of cavity was high among SMPTB with DM(95.9%).The negative conversion rate at the end of intensive phrase and cure rate among SMPTB patients with DM or IGT was 77.4% and 86.3% respectively,which were significantly lower than that among the SMPTB patients with normal level of blood glucose(88.1%,91.7%)(P<0.05). Conclusion The prevalence of DM and IGT among SMPTB patients is higher than that among general population.SMPTB patients with DM have special Xray radiographic manifestation which helps case detection,diagnosis and treatment.The awareness of abnormal level of blood glucose is low among SMPTB patients with DM and IGT.Anti-TB drug resistant rate among retreated SMPTB patients with DM or IGT is higher,which influence the sputum conversion and treatment outcome.It should be paid high attention that DM and IGT tampered TB treatment.

Key words: Pulmonary tuberculosis/epidemiology, Diabetes, Henan province