Comparative analysis of epidemiological characteristics of pulmonary tuberculosis complicated with diabetes and simple pulmonary tuberculosis

doi:10.19982/j.issn.1000-6621.20220047

Abstract

Abstract:

Objective: To analyze the characteristics of tuberculosis patients complicated with diabetes registered in the Tuberculosis Outpatient Department of Beijing Center for Disease Prevention and Control, and to provide evidence for the prevention and treatment of tuberculosis-diabetes comorbidity. Methods: The epidemiological characteristics of 261 tuberculosis patients complicated with diabetes registered in the Tuberculosis Outpatient Department of Beijing Center for Disease Prevention and Control from 2014 to 2021 were descriptively compared with those of 1839 patients with tuberculosis alone during the same period, including gender, age, treatment classification, discovery method, positive rate of etiology, smear positive rate, culture positive rate, drug resistance rate of rifampicin, sputum smear negative conversion rate at the end of the 2nd month, treatment success rate, delay rate of visit and diagnosis,time interval of visit and diagnosis. Results: The rate of retreatment in patients with tuberculosis combined with diabetes (16.48% (43/261)) was significantly higher than that in patients with tuberculosis alone (8.70% (160/1839), χ²=15.822,P<0.001), and the proportion of active detection (7.28% (19/261)) was significantly lower than that of simple tuberculosis (13.05% (240/1839), χ²=7.040,P<0.01). The positive rate of etiology in patients with tuberculosis combined with diabetes (65.90% (172/261))was significantly higher than that in patients with tuberculosis alone (35.07% (645/1839), χ²=91.381, P<0.001). Sputum smear negative conversion rate at the end of 2nd month and treatment success rate in patients with tuberculosis combined with diabetes were lower than those of patients with simple tuberculosis (84.62% (110/130) vs. 91.15% (412/452), χ²=4.663, P=0.031; 80.46% (210/261) vs. 87.71% (1613/1839),χ²=10.495,P=0.001).There was no significant difference in the drug resistance rate of rifampicin (3.07% (8/261) vs. 1.41% (26/1839), χ²=2.945,P=0.086).The visit delay rate and the visit time of patients with tuberculosis combined with diabetes were significantly higher than those of patients with simple tuberculosis (52.87% (138/261) vs. 42.09% (774/1839), χ²=10.822, P=0.001; 16 (2, 53) d vs. 9 (0,37) d, U=2.775, P=0.006).There were no significant differences in diagnosis delay rate and diagnosis time (32.57% (85/261) vs. 31.92% (587/1839), χ²=0.044,P=0.834; 7 (0,24) d vs. 7 (1,20) d, U=0.167,P=0.867). Conclusion: Patients with tuberculosis complicated with diabetes had the characteristics of high positive rate of etiology, high retreatment rate, high delay rate in treatment, long interval between visits,low active detection rate, low sputum smear negative conversion rate and low success rate of treatment.

Key words: Tuberculosis,pulmonary, Diabetes mellitus, Comorbidity, Epidemiologic study characteristics as topic, Comparative study

CLC Number:

R521
R587.1

XU Jing, LUO Ping, HE Xiao-xin. Comparative analysis of epidemiological characteristics of pulmonary tuberculosis complicated with diabetes and simple pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2022, 44(5): 494-499. doi: 10.19982/j.issn.1000-6621.20220047

Figures/Tables 2

References 25

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年份	肺结核患者(例)	合并糖尿病患者(例)	并发率 (%)
2014	356	20	5.62
2015	251	28	11.16
2016	255	28	10.98
2017	206	20	9.71
2018	284	46	16.20
2019	270	42	15.56
2020	239	36	15.06
2021	239	41	17.15
合计	2100	261	12.43

特征	肺结核合并糖尿病组(261例)	单纯肺结核组 (1839例)	统计检验值	P值
性别[例(构成比,%)]			χ²=36.570	<0.001
男性	203(77.78)	1071(58.24)
女性	58(22.22)	768(41.76)
年龄[例(构成比,%)]			χ²=295.745	<0.001
14~17岁	1(0.38)	39(2.12)
18~44岁	28(10.73)	1187(64.55)
45~59岁	85(32.57)	251(13.65)
60~92岁	147(56.32)	362(19.68)
发现方式[例(比率,%)]			χ²=7.040	0.008
主动发现	19(7.28)	240(13.05)
健康检查	17(6.51)	220(11.96)
主动筛查	2(0.77)	20(1.09)
被动发现	241(92.34)	1594(86.68)
直接就诊	78(29.89)	649(35.29)
转诊	156(59.77)	902(49.05)
追踪	3(1.15)	27(1.47)
推介	4(1.53)	16(0.87)
其他	1(0.38)	5(0.27)
治疗分类[例(构成比,%)]			χ²=15.822	<0.001
初治	218(83.52)	1679(91.30)
复治	43(16.48)	160(8.70)
病原学检测结果[例(构成比,%)]			χ²=91.381	<0.001
病原学阳性	172(65.90)	645(35.07)
阴性及无结果	89(34.10)	1194(64.93)
痰涂片[例(构成比,%)]			χ²=72.623	<0.001
涂阳	130(49.81)	452(24.58)
非涂阳	131(50.19)	1387(75.42)
痰培养[例(构成比,%)]			χ²=58.985	<0.001
培阳	124(47.51)	456(24.80)
非培阳	137(52.49)	1383(75.20)
利福平耐药[例(构成比,%)]			χ²=2.945	0.086
是	8(3.07)	26(1.41)
否	253(96.93)	1813(98.59)
就诊延迟[例(构成比,%)]			χ²=10.822	0.001
是	138(52.87)	774(42.09)
否	123(47.13)	1065(57.91)
确诊延迟[例(构成比,%)]			χ²=0.044	0.834
是	85(32.57)	587(31.92)
否	176(67.43)	1252(68.08)
就诊时间[d,M(Q₁,Q₃)]	16(2,53)	9(0,37)	U=2.775	0.006
确诊时间[d,M(Q₁,Q₃)]	7(0,24)	7(1,20)	U=0.167	0.867
2个月末痰涂片阴转[例(构成比,%)]^a			χ²=4.663	0.031
是	110(84.62)	412(91.15)
否	20(15.38)	40(8.85)
治疗成功[例(构成比,%)]			χ²=10.495	0.001
是	210(80.46)	1613(87.71)
否	51(19.54)	226(12.29)