印度 1 型糖尿病青壮年患者肺结核患病率。

IF 2.3 Multidisciplinary Respiratory Medicine Pub Date : 2016-05-10 eCollection Date: 2016-01-01 DOI:10.1186/s40248-016-0058-z
Abilash Nair, Randeep Guleria, Devasenathipathy Kandasamy, Raju Sharma, Nikhil Tandon, Urvashi B Singh, Ravinder Goswami
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引用次数: 0

摘要

背景:关于1型糖尿病患者肺结核(PTB)患病率的信息很有限。我们评估了在一家三级医院门诊就诊的 1 型糖尿病患者中肺结核的发病率。方法:通过临床检查和胸部放射摄影对 151 名 1 型糖尿病患者进行了肺结核筛查。对临床和放射学特征提示可能患有肺结核的患者以及既往有肺结核病史的患者进行痰酸-快速杆菌试验(AFB)和结核分枝杆菌(M.tb)培养。此外,还对患者前两年的平均糖化血红蛋白(HbA1c)进行了评估。痰培养呈阳性的患者由肺科医生进行治疗:结果:5/151 名患者有呼吸道症状和影像学检查结果提示为肺结核。20/151例患者无症状,但有肺结核病史。5 名无症状患者中的 4 人和 12 名曾患过肺结核的患者痰培养呈结核杆菌阳性,因此 1 型糖尿病患者痰培养阳性率为 10.6%。痰培养阳性和未呈阳性的患者的平均 HbA1c 值相当。血沉和曼氏试验在这些组别中没有区分作用。四名有临床症状的 M.tb 培养阳性患者和四名无症状的 M.tb 痰培养阳性患者两次(间隔 6 周)接受了抗结核治疗(ATT)。对仅有一次痰培养呈阳性的患者进行了密切随访:结论:在印度,1 型糖尿病患者的肺结核发病率很高。结论:在印度,1 型糖尿病患者的肺结核发病率很高,需要通过痰 M.tb 培养积极筛查肺结核,以便及早开始治疗并防止在社区传播。
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Prevalence of pulmonary tuberculosis in young adult patients with Type 1 diabetes mellitus in India.

Background: There is limited information on prevalence of pulmonary tuberculosis (PTB) in patients with type-1-diabetes. We assessed the prevalence of PTB in patients with type-1-diabetes attending the outpatient-clinic in a tertiary-care hospital.

Methods: 151 patients with type-1-diabetes were screened for PTB by clinical examination and chest-radiography. Sputum Acid-Fast Bacilli Test (AFB) and Mycobacterium tuberculosis (M.tb) culture were performed in patients with clinical and radiological features suggestive of a possibility of PTB and also in those with history of PTB in the past. Their average glycated haemoglobin (HbA1c) during preceding 2 years was assessed. Sputum culture positive patients were managed by a pulmonologist.

Results: 5/151 patients had respiratory symptoms and radiographic findings suggestive of PTB. 20/151 patients were asymptomatic but had history of PTB. Four of the five symptomatic patients and 12 with past PTB were positive for sputum M.tb by culture, giving a prevalence of 10.6 % sputum culture positive in type-1-diabetes. Average HbA1c was comparable in patients with and without positive sputum culture. ESR and Mantoux test were not discriminatory in these groups. Four clinically symptomatic M.tb culture positive and four asymptomatic patients with sputum culture positive for M.tb on two occasions (6 weeks apart) were put on antitubercular treatment (ATT). Patients who were culture positive for M.tb only on one occasion were kept on a close follow up.

Conclusions: Patients with type-1-diabetes mellitus in India have high prevalence of PTB. They need to be actively screened for PTB by sputum M.tb culture in order to initiate early treatment and to prevent transmission in the community.

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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
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0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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