本文選題：肺結(jié)核　切入點：糖尿病　出處：《青島大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的肺結(jié)核合并糖尿病(PTB-DM)患者在臨床表現(xiàn)及機(jī)體狀況等方面有別于單純肺結(jié)核患者。本文旨在通過了解肺結(jié)核合并糖尿病患者的臨床特征與營養(yǎng)狀況,為其臨床診療與營養(yǎng)支持提供具有針對性的建議。 方法選取某市胸科醫(yī)院2011年12月至2012年8月間住院的116例肺結(jié)核合并糖尿病患者為PTB-DM組,另選取該院同期住院的136例單純肺結(jié)核(PTB)患者為PTB組,比較兩組入院時臨床癥狀的發(fā)生率、血沉(ESR)加快率、痰涂片陽性率、空洞發(fā)生率和營養(yǎng)狀況相關(guān)指標(biāo)如總膽固醇(TC)、甘油三酯(TG)、體質(zhì)指數(shù)(BMI)、血紅蛋白(Hb)、血清白蛋白(ALB)及淋巴細(xì)胞計數(shù)(TLC)。 結(jié)果在呼吸道癥狀方面,PTB-DM組患者咳嗽、咳痰與咯血的發(fā)生率分別為97.4%、90.5%和31.0%,高于PTB組的88.2%、80.9%和14.0%,差異有統(tǒng)計學(xué)意義(P0.05)；在全身癥狀方面,PTB-DM組患者乏力和食欲減退的發(fā)生率分別為68.1%和40.0%,高于PTB組的55.1%和27.9%,差異有統(tǒng)計學(xué)意義(P0.05)；ESR加快的檢出率,PTB-DM組與PTB組分別為81.9%和66.9%,PTB-DM組明顯升高(P0.05)；PTB-DM組患者痰涂片陽性的檢出率為78.4%,高于PTB組的66.2%,差異有統(tǒng)計學(xué)意義(P0.05)；PTB-DM組患者病灶所在肺野數(shù)多于2個的患者所占比例為61.20%,而PTB組為53.7%,差異無統(tǒng)計學(xué)意義(P0.05)。PTB-DM組空洞形成率為63.8%,高于PTB組的39.7%,差異有統(tǒng)計學(xué)意義(P0.05)。營養(yǎng)狀況分析顯示,TC和TG水平PTB-DM組分別為4.39mmol/L和1.43mmol/L,PTB組分別為3.97mmol/L和1. Olmmol/L,兩組間差異有統(tǒng)計學(xué)意義(P0.05)；PTB-DM組的TLC為1.36×109/L,明顯低于PTB組的1.52×109/L(P0.05)；PTB-DM組與PTB組的BMI分別為21.60kg/m2和21.10kg/m2,Hb分別為126.62g/L和129.93g/L,ALB分別為39.23g/L和39.08g/L,兩組間差異均無統(tǒng)計學(xué)意義(P0.05)；高膽固醇血癥、高甘油三脂血癥和TLC減少的發(fā)生率PTB-DM組分別為19.8%、28.4%和61.2%,均高于PTB組的8.8%、5.1%和45.6%,差異有統(tǒng)計學(xué)意義(P0.05),消瘦、貧血和低白蛋白血癥的發(fā)生率PTB-DM分別為16.4%、35.3%和24.1%,PTB組分別為19.1%、25.7%和21.3%,兩組間的差異無統(tǒng)計學(xué)意義(P0.05)。 結(jié)論與PTB患者相比,PTB-DM患者的病情相對較重,高膽固醇血癥和高甘油三脂血癥的發(fā)生率增高,臨床上應(yīng)給予具有針對性的診療措施及飲食指導(dǎo)。
[Abstract]:Objective to study the clinical features and nutritional status of patients with pulmonary tuberculosis complicated with diabetes mellitus (PTB-DM). To provide targeted advice for its clinical diagnosis and treatment and nutrition support. Methods A total of 116 pulmonary tuberculosis patients with diabetes mellitus were selected as PTB-DM group from December 2011 to August 2012, and 136 patients with simple pulmonary tuberculosis were selected as PTB group. The incidence of clinical symptoms, the accelerated rate of ESR and the positive rate of sputum smear were compared between the two groups. The incidence of cavities and nutritional status such as total cholesterol TCX, triglyceride TGN, body mass index (BMI), hemoglobin (HB), serum albumin (ALB) and lymphocyte count (TLC) were measured. Results in terms of respiratory symptoms, the patients in PTB-DM group had cough. The incidences of expectoration and hemoptysis were 90.5% and 31.0%, respectively, which were higher than those in PTB group (88.20.9% and 14.0%, respectively), the difference was statistically significant (P 0.05), the incidence of fatigue and anorexia in PTB-DM group was 68.1% and 40.0% respectively, which was higher than that in PTB group (55.1% and 27.9). The positive rate of sputum smear in PTB-DM group and PTB group was 81.9% and 66.9 respectively. The positive rate of sputum smear in PTB-DM group was 78.4%, which was higher than that in PTB group (66.2%). The difference was statistically significant in the number of pulmonary fields in PTB-DM group. The proportion of patients in two groups was 61.20 and 53.7in PTB group. There was no significant difference in cavitation formation rate between P0.05 and PTB-DM groups, which was higher than that in PTB group (39.7%). The nutritional status analysis showed that TC and TG levels in PTB-DM group were 4.39 mmol / L and 1.43 mmol / L PTB respectively. The TLC of PTB-DM group was 1.36 脳 10 9 / L, which was significantly lower than that of PTB group (1.52 脳 10 9 / L P 0.05%) and BMI of PTB-DM group and PTB group were 21.60 kg / m ~ 2 and 21.10 kg 路m ~ (-2) h ~ (-1) respectively. The TLC of PTB-DM group was 39.23 g / L and 39.08 g / L, respectively, and the BMI of PTB group was 21.60 kg / m ~ (2) and 21.10 kg 路m ~ (-2) H _ b of PTB group, respectively. The difference between the two groups was 39.23 g / L and 39.08 g / L, respectively. There was no significant difference between the two groups in hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia, hypercholesterolemia and hypercholesterolemia. The incidence of hypertriglyceridemia and reduction of TLC in PTB-DM group was 28.4% and 61.2%, respectively, which was higher than that in PTB group (8.8% and 45.6%). The difference was statistically significant (P 0.05). The incidence of anemia and hypoalbuminemia in the PTB-DM group was 16.435. 3% and 24. 1%, respectively. The incidence of anemia and hypoalbuminemia in the PTB group was 19. 1% and 21. 3%, respectively. There was no significant difference between the two groups (P 0. 05). Conclusion compared with the patients with PTB, the patients with PTB-DM are more serious, the incidence of hypercholesterolemia and hypertriglyceridemia is higher.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R521;R587.1

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