摘要
目的分析二甲双胍对合并肺结核2型糖尿病(T2DM)患者肺部炎症及病灶吸收的影响。方法选取2023年1月-2023年12月沧州市中心医院收治的T2DM合并肺结核患者88例,根据治疗方案,分为对照组39例和研究组49例,对照组患者采用达格列净片治疗,研究组在对照组基础上联合盐酸二甲双胍片治疗,两组均连续治疗2个月,比较治疗前后两组患者糖代谢指标、炎症指标和免疫功能指标,统计治疗后患者肺部病灶吸收率、空洞闭合率、痰菌转阴率和继发感染率。结果治疗后,两组糖代谢指标空腹血糖(FPG)、餐后2 h血糖(2hPG)及糖化血红蛋白(HbAlc)和炎症指标降钙素原(PCT)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)和红细胞沉降率(ESR)水平均降低(P<0.05),且研究组低于对照组(P<0.05);两组免疫功能指标CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平均升高(P<0.05),且研究组高于对照组(P<0.05),CD_(8)^(+)均降低(P<0.05),且研究组低于对照组(P<0.05);治疗后,研究组肺部病灶吸收率(93.88%)、痰转阴率(67.35%)和空洞闭合率(63.27%)均高于对照组(P<0.05)。结论二甲双胍治疗T2DM合并肺结核患者可有效控制血糖水平,降低炎症因子水平,改善血流动力学指标,增强免疫功能,同时提高肺部病灶吸收率、痰菌转阴率和空洞闭合率。
OBJECTIVE To observe the effect of metformin on pulmonary inflammation,absorption of lesions of the type 2 diabetes mellitus(T2DM)patients complicated with tuberculosis.METHODS A total of 88 T2DM patients complicated with tuberculosis who were treated in Cangzhou Central Hospital from Jan 2023 to Dec 2023 were enrolled in the study and were divided into the control group with 39 cases and the study group according to the treatment program.The control group was treated with dapagliflozin tablets,while the study group was given metformin hydrochloride tablets combined with dapagliflozin tablets,and both groups were treated for 2 consecutive months.The glycometabolism indexes,inflammatory factors and immune function indexes were observed and compared between the two groups of patients before and after the treatment.The absorption rates of pulmonary foci,closure rate of cavity,negative conversion rate of sputum bacteria and incidence of secondary infection were statistically analyzed after the treatment.RESULTS The levels of glycometabolism indexes fasting blood glucose(FBG),2 hour postprandial plasma glucose(2hPG)and glycosylated hemoglobin(HbAlc),inflammatory indexes procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)as well as erythrocyte sedimentation rate(ESR)were reduced in the two groups after the treatment(P<0.05);the levels of the above indexes of the study group were lower than those of the control group(P<0.05).The levels of immune function indexes CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the two groups were elevated(P<0.05),and the levels of the above indexes of the study group were higher than those of the control group(P<0.05);while the CD_(8)^(+)level of the two groups was reduced(P<0.05),and the CD_(8)^(+)level of the study group was lower than that of the control group(P<0.05).The absorption rates of foci(93.88%),negative conversion rate of sputum bacteria(67.35%)and closure rate of cavity(63.27%)were higher in the study group than in the control
作者
杨柳
郭晋平
吴金华
李智存
YANG Liu;GUO Jin-ping;WU Jin-hua;LI Zhi-cun(Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第17期2626-2630,共5页
Chinese Journal of Nosocomiology
基金
河北省卫生健康委医学科学研究课题计划项目(20232133)。
关键词
二甲双胍
2型糖尿病合并肺结核
炎症
肺部病灶吸收
Metformin
Type 2 diabetes mellitus complicated with tuberculosis
Inflammation
Absorption of pul-monary focus
