Analysis Of Clinicanl Characteristics Of Type 2 Diabetes Meillitus Complicated With Initial Treatment Of Pulmonary Tuberculosis

Objective:The incidence of diabetes mellitus and tuberculosis is increasing globally each year,and clinical studies have found that the two diseases are mutually reinforcing.The early clinical manifestations of diabetes mellitus combined with tuberculosis are atypical and difficult to diagnose,and the disease is often severe when detected.In this study,a retrospective analysis of type 2diabetes mellitus combined with primary pulmonary tuberculosis was conducted,and a matched comparison was made with primary pulmonary tuberculosis alone during the same period,with the aim of gaining a full understanding of type 2 diabetes mellitus combined with primary pulmonary tuberculosis,and providing a scientific basis for early diagnosis,prognosis and treatment of type 2diabetes mellitus combined with primary pulmonary tuberculosis.Methods: In this paper,we retrospectively selected the treatment data of patients from Tongliao Infectious Diseases Hospital from January 2017 to December 2020,and those diagnosed with type 2 diabetes mellitus combined with primary pulmonary tuberculosis were the study group and those diagnosed with primary pulmonary tuberculosis alone were the control group.The clinical characteristics of type 2 diabetes mellitus combined with primary pulmonary tuberculosis were statistically analysed(study group)and regression.Results:Compared with primary TB alone,a higher proportion of patients with type 2 diabetes mellitus combined with primary TB were over 40 years of age(P < 0.05).The proportion of patients with type 2 diabetes combined with primary TB who were underweight was significantly higher than that of patients with type 2 diabetes combined with primary TB(P < 0.05).The proportion of patients with type 2 diabetes combined with primary TB who smoked and drank alcohol was significantly higher than that of patients with primary TB alone(P < 0.001).There was no significant difference between the two groups in terms of gender,ethnicity,marital status and living environment.There was no significant difference between the two groups in terms of clinical manifestations,such as fever,night sweats,malaise,cough,sputum and weight loss(P>0.05);however,haemoptysis was lower in patients with type 2 diabetes combined with primary TB than in patients with primary TB alone(P<0.01).In terms of laboratory tests,including TB antibodies,sputum Mycobacterium tuberculosis,T-SPOT and sputum culture,the positive rate of these tests was relatively higher in patients with type 2 diabetes mellitus combined with primary TB(P<0.05).In terms of chest CT imaging,compared with primary TB alone,type 2 diabetes combined with primary TB had a higher probability of lesions in multiple lobes and lesions in the anterior segment of the upper lobe(P<0.05),but there was no significant difference between the two groups in terms of the probability of lesions in the posterior segment of the upper lobe and the dorsal segment of the lower lobe(P>0.05);in terms of the incidence of cavitation,pleural thickening and pleural effusion,compared with primary In terms of the incidence of cavitation,pleural thickening and pleural effusion,type 2 diabetes combined with primary TB was significantly higher compared with primary TB alone(P<0.001);the incidence of mediastinal lymph node enlargement was still higher in type 2 diabetes combined with primary TB(P<0.05);the other imaging manifestations such as solid lung lesions,tree bud sign and atelectasis were not significantly different between the two groups(P>0.05).In terms of cure rate,primary TB alone was better than primary TB in combination with type 2 diabetes(P<0.001).Correlation analysis showed that there was a correlation between diabetes and the incidence of bronchial tuberculosis(γ=0.162,P<0.05),cavitary lesions(γ=0.296,P<0.001)and bacteriophage positivity(γ=0.228,P<0.001).In the well-controlled group,the incidence of cavitation was significantly lower(P < 0.001),as was the incidence of bronchial tuberculosis and bacteriophage(P < 0.05),independent of the glycaemic control regimen.Conclusion: Patients with type 2 diabetes mellitus combined with primary pulmonary tuberculosis are predominantly middle-aged and elderly men,and smoking,alcohol consumption,low BMI status and poor glycaemic control may increase the risk of type 2 diabetes mellitus combined with primary pulmonary tuberculosis.Patients with type 2 diabetes combined with primary TB are more likely to develop bronchial tuberculosis,cavitary lung lesions and a higher rate of sputum positivity,and the incidence of these conditions increases with poor glycaemic control,independent of the glucose control regimen.