关键词: 糖尿病并发症, 结核, 肺/并发症, 血红蛋白A, 糖基化

Abstract: Objective To investigate the relationship between the clinical manifestations and the value of glycosytated hemoglobin A1c (HbA1c) in patients with diabetes combined with pulmonary tuberculosis. Methods Three hundred and ninety-five cases with diabetes combined with pulmonary tuberculosis admitted in our hospital from the January 1, 2011 to December 31, 2011 were divided into three groups based on the HbA1c value detected the day after admission according to the standard from China Diabetes Prevention Guidelines. The three groups were as follows: group Ⅰ with HbA1c less than 6.5%(the well control group,40 cases), group Ⅱ with HbA1c ranged from 6.5% to 7.5%(the medium control group, 63 cases) and group Ⅲ with HbA1c more than 7.5%(the poor control group, 292 casas). The status of Mycobacterium tuberculosis in sputum and the characteristics of pulmonary lesions in CT imaging were compared anong the three groups. Statistics analysis was used the SPSS 19.0 software. Group t test was applied for measurement data and correction t test was applied if variance was heterogeneity. χ² test was applied for count data and linear trendχ² test was applied for linear trend of the three subgroups. Results The sputum positive rate was 50.0%(20/40) in group Ⅰ, 73.0%(46/63) in group Ⅱ and 90.4%(264/292) in group Ⅲ, respectively. The sputum positive rate in the group Ⅱ was much higher than that in the group Ⅰ and in the group Ⅱ (χ²=47.83,P<0.01). Morever, the sputum positive rate in the group Ⅲ was much higher than that in the group Ⅰ (χ²=5.63,P<0.05). The positive rate of sputum bacillus in the three groups presented an increasing trend(χ²_trend=47.46, P<0.01). The discovery rate of caseous lesions was 45.0%(18/40) in group Ⅰ, 58.7%(37/63)in group Ⅱ and 80.1%(234/292)in group Ⅲ, respectively. The discovery rate of caseous lesions in the group Ⅲ was much higher than that in the group Ⅰ and in the group Ⅱ (χ²=30.08,P<0.01).The discovery rate of caseous lesions in the three groups presented an increasing trend(χ²_trend=29.67, P<0.01). The discovery rate of worm-eaten-like cavities was 12.5%(5/40), 14.3%(9/63) and 28.4%(83/292)in the three groups, respectively. The discovery rate of worm-eaten-like cavities in the Ⅲ group was much higher than that in the group Ⅰ and in the group Ⅱ (χ²=9.08, P<0.05). The discovery rate of worm-eaten-like cavities in the three groups presented an increasing trend(χ²_trend=8.17, P<0.05).The discovery rate of caseous cavities was 25.0%(10/40)，27.0%(17/63) and 53.1%(155/292) in the three groups. The discovery rate of caseous cavities in the group Ⅲ was much higher than that in the group Ⅰ and in the group Ⅱ (χ²=22.16, P<0.01).The discovery rate of caseous cavities in the three subgroups presented an increasing trend(χ²_trend=19.57, P<0.05). Conclusion The relationship between the value of glycosytated hemoglobin and the clinical features is close in of the paitents with diabetes combined with pulmonary tuberculosis.

Key words: Diabetes complications, Tuberculosis, pulmonary/complications, Hemoglobin A, Glycosylated