糖尿病和结核病:新出现的对医疗保健的双重威胁

Sahana Shetty, Joseph M Pappachan, C. Fernandez
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摘要

尽管近几十年来发达国家的结核病发病率有所下降,但即使到了 21 世纪,结核病(TB)仍然是全球医疗保健领域的一个巨大挑战。由于糖尿病(DM)患者的免疫功能失调,糖尿病(DM)是导致肺结核发病和持续存在的重要风险因素。由于糖尿病和肺结核造成了严重的免疫改变,这两种疾病同时存在于同一个人身上也会加重疾病的严重性、并发症和治疗失败的几率。结核病和 DM 之间的危险相互作用涉及各种复杂的细胞和体液免疫因素,其中一些因素至今仍不为人所知。确定糖尿病患者患结核病的危险因素,反之亦然,以确保早期诊断和治疗,防止这种不祥的并存引起并发症,是非常重要的。Shi 等人在最近一期《世界糖尿病杂志》(World Journal of Diabetes)上发表的研究报告中,详细阐述了中国大量糖尿病患者中结核病发病的相关因素。来自世界不同地区的更多此类研究成果有望增进我们的知识,以应对结核病对糖尿病患者健康造成的破坏。
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Diabetes and tuberculosis: An emerging dual threat to healthcare
Tuberculosis (TB) remains a huge global healthcare challenge even in the 21st century though the prevalence has dropped in developed countries in recent decades. Diabetes mellitus (DM) is an important risk factor for the development and perpetuation of TB owing to the immune dysfunction in patients with DM. The coexistence of both diseases in the same individual also aggravates disease severity, complications, and chance of treatment failure because of gross immune alterations posed by DM as well as TB. Various complex cellular and humoral immunological factors are involved in the dangerous interaction between TB and DM, some of which remain unknown even today. It is highly important to identify the risk factors for TB in patients with DM, and vice versa, to ensure early diagnosis and management to prevent complications from this ominous coexistence. In their research study published in the recent issue of the World Journal of Diabetes, Shi et al elaborate on the factors associated with the development of TB in a large cohort of DM patients from China. More such research output from different regions of the world is expected to improve our knowledge to fight the health devastation posed by TB in patients with diabetes.
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