关键词: 结核,肺/并发症, 糖尿病并发症, 胆固醇, 甘油三酯类, 营养状况

Abstract: Objective The objective of this study was to find out the clinical characteristics and nutritional status of the pulmonary tuberculosis patients with diabetes mellitus (PTB-DM) and provide the targeted suggest for their clinical treatment and nutritional support.  Methods One hundred and sixteen inpatients with pulmonary tuberculosis complicated with diabetes mellitus in Qingdao Chest Hospital from 2011.12 to 2012.8 were recruited as the PTB-DM group. And 136 pulmonary tuberculosis inpatients without diabetes mellitus of this hospital in the same period were selected as the PTB group. Between the two groups, compared the incidences of clinical symptoms, erythrocyte sedimentation rate (ESR) sped up, sputum smear positive and the nutrition status indicators including total cholesterol (TC), triglyceride (TG) and total lymphocyte count (TLC). Divided the PTB-DM group into well-controlled group（34 cases） and poor-controlled group（82 cases） according to their fasting blood glucose, and analysed the effect of glycemic control on clinical characteristics at the time of admission.  Results The incidences of cough，expectoration，hemoptysis，fatigue，anorexia，ESR sped up and positive sputum smear in PTB-DM group were 97.4%（113/116），90.5%（105/116），31.0%（36/116），68.1%（79/116），39.7%（46/116），81.9%（95/116）and 78.4%（91/116）, while those of PTB group were 88.2%（120/136），80.9%（110/136），14.0%（19/136），55.1%（75/136），27.9%（38/136），66.9%（91/136） and 66.2%(90/136）respectively. These values in PTB-DM group were obviously higher than those in PTB group(χ²=7.565，4.639，10.684，4.422，3.866，7.272，4.659 respectively；all P<0.05).The incidences of expectoration，hemoptysis，fatigue and positive sputum smear in well-controlled group were 79.4%（27/34），17.6%（6/34），52.9%（18/34）and 64.7%（22/34），which were significantly lower than 95.1%（78/82），36.6%（30/82），74.4%（61/82）and 84.1%（69/82） in poor-controlled group（χ²= 6.911，4.028，5.090，5.373 respectively；all P<0.05）.The analyses of nutrition status showed that TC and TG in PTB-DM group were（4.39±1.17） mmol/L and （1.43±0.91） mmol/L while those in PTB group were （3.97±0.97） mmol/L and （1.01±0.51） mmol/L，PTB-DM group was higher than PTB group with significant statistic differences（t=-3.237，t′=-4.457 respectively；all P<0.05）；the TLC of PTB-DM group was（1.36±0.52）×10⁹/L，which was lower than（1.52±0.64）×10⁹/L in PTB group（t′=2.000，P<0.05）. Conclusion The PTB-DM patients’ condition are more serious and the TC and TG are higher. They should be given targeted diagnosis，treatment measures and diet guidances clinically.

Key words: Tuberculosis,pulmonary/complications, Diabetes complications, Cholesterol, Triglycerides, Nutritional status