樊向明,焦书平,新新
FAN Xiangming,JIAO Shuping,XIN Xin

• 1:冀中能源峰峰集团骨科医院内一科
• 2:冀中能源峰峰集团邯郸医院急诊科
• 3:苏州医科大学第二附属医院

摘要(Abstract)：

目的:探讨2型糖尿病(DM2)并发肺结核(TB)感染患者的CT影像特征。方法:DM2并发TB感染患者98例作为研究组,同时选取同期入院治疗的TB非糖尿病(DM)患者100例作为对照组,对比两组患者的临床资料及CT影像特征;研究组中根据DM病程长短进一步将研究组分为研究组A(DM病程≥10年,n=50)和研究组B(DM病程<10年,n=48),对比不同DM病程患者临床资料及CT影像特征。结果:研究组患者中61例(63.26%)具有高血压、慢性肾功能不全、心衰、心律失常等合并症,显著高于对照组患者,差异有统计学意义(P<0.001);双肺病变(OR,2.39;95%CI,1.34~4.25;P=0.003)、所有肺叶病变(OR,2.79;95%CI,1.24~6.27;P=0.013)以及淋巴结肿大(OR,1.98;95%CI,1.10~3.55;P=0.022)均为DM合并TB的独立预测因素;在研究组中,研究组A患者的平均年龄高于研究组B患者(P<0.05);两组不同病程DM2合并TB患者的CT影像学表现差异无统计学意义(P>0.05)。结论:DM2合并TB患者的CT检查有明显示影像子特征,认识这些特征有助于准确诊断和临床治疗方案的选择。
Objective: To investigate the CT features of patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis. Methods: 98 patients with type 2 diabetes complicated with pulmonary tuberculosis were selected as research group; 100 cases of non diabetic patients with pulmonary tuberculosis treated at the same period were selected as control group; the clinical data and CT imaging features were compared between the two groups. According to the duration of diabetes,research group was further divided into the study group A( DM duration ≥10 years,n = 50) and the study group B( DM duration < 10 years,n = 48) to compare the effects of different diabetic courses on the clinical data and CT imaging features. Results: In the study group,61( 63. 26%) cases had comorbidities,such as hypertension,chronic renal failure,heart failure and arrhythmia,which were significantly higher than those in the control group,differences were statistically significant( P <,0. 001). Double lung lesions( OR,2. 39; 95% CI,1. 34 ~ 4. 25; P = 0. 003),all lobe lesion( OR,2. 79; 95% CI,1. 24~ 6. 27; P = 0. 013) and lymphadenopathy( OR,1. 98; 95% CI,1. 10 ~ 3. 55; P = 0. 022) were independent predictors of DM with TB. The average age of the patients in the study group A was higher than that in the study group B( P < 0. 05). There was no significant difference in CT imaging betweentwo groups of TB patients with different DM courses( P > 0. 05). Conclusion: Patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis infection CT imaging showed bilateral lung lesions,involving all lung and lymph nodes; CT can help strengthen the diagnosis of patients and provide the basis and reference for the clinical treatment.

关键词(KeyWords)： 糖尿病,非胰岛素依赖型;结核,肺;感染;影像学特征;CT
diabetes mellitus,non insulin dependent;pulmonary tuberculosis;infection;imaging features;CT

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 樊向明,焦书平,新新
FAN Xiangming,JIAO Shuping,XIN Xin

DOI: 10.19367/j.cnki.1000-2707.2017.10.026

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