摘要
目的探讨二甲双胍在抗结核治疗及结核病灶愈合过程中的辅助作用。方法从2012年1月1日—2016年12月31日北京胸科医院收治的肺结核合并2型糖尿病患者1 851例中随机抽取患者,依据使用二甲双胍、胰岛素等降糖药的不同将患者分组:未使用任何降糖药物(组一);未使用二甲双胍+使用胰岛素以及其他降糖药(组二);只使用二甲双胍(组三);使用二甲双胍+胰岛素或其他降糖药(组四)。分析每组患者基本信息(年龄、性别、职业)、生化检查以及影像学特点。计数资料使用χ2检验,计量资料使用t检验。结果共纳入515例患者,四组分别为156例,247例,19例和93例。四组患者在性别、年龄、职业分布上差异无统计学意义(P>0.05)。四组糖化血红蛋白差异有统计学意义(P<0.05),其中单纯使用二甲双胍组血糖控制在正常范围内的患者比例远高于其他三组。胸部影像学复查结果,使用二甲双胍的组三与组四在左肺与右肺的病变比例分别为68.4%、63.2%和43.0%、39.8%,低于未使用二甲双胍的组一(85.3%、84.0%)和组二(83.4%、82.6%),并且单纯使用二甲双胍组结核空洞闭合比例比其他组高,组一组二空洞未闭合或增多的比例高于组三、组四,四组出现结核病灶和空洞的差异有统计学意义(P<0.05)。结论降糖药二甲双胍对于抗结核治疗和结核病灶的愈合有辅助作用,有利于近期血糖的控制,促进结核空洞的闭合。
Objective To explore the auxiliary role of metformin in the treatment of tuberculosis and the healing process of tuberculosis. Methods Randomly selected 1 851 treated pulmonary tuberculosis with type 2 diabetes patients in Beijing Chest Hospital from year 2012.1.1 to 2016.12.31, the patients were divided into four groups according to metformin,insulin and other hypoglycemic agents： don＇t use any antidiabetic drugs （group 1）;not using metformin ＋ using insulin and other hypoglycemic agents （group 2）;use metformin only （group 3）;use metformin ＋ insulin or other hypoglycemic agents （group 4）.The basic information （age, sex, occupation）, biochemical examination and imaging characteristics of each group were analyzed.The counting data was tested by χ2 test, and the measurement data was tested by t test. Results A total of 515 patients were enrolled, the four groups were 156 cases, 247 cases, 19 cases and 93 cases, respectively. There was no statistically significant difference in gender, age and occupational distribution in the four groups （P〉0.05） .There was statistically significant difference of glycosylated hemoglobin in the four groups（P 〈0.05）, and the proportion of patients who were only using metformin in the normal range was much higher than other three groups. Chest imaging review results, the proportion of lesions in the left lung and the right lung in group three and group four （68.4%, 63.2%, and 43.0%, 39.8%）, was lower than group one and group two without metformin （85.3%, 84.0% and 83.4%, 82.6%）, and the tuberculosis cavity closure proportion in simply use the metformin group was higher than other groups, the proportion of tuberculosis cavity was not closed or increasing in group one and two were higher than the group three and four, there was statistically significant difference between the four groups of tuberculosis lesions and cavity （P〈 0.05）. Conclusion Metformin is helpful for the treatment of tuberculosis and the healing of the tuberculosis, which is beneficial to the recent blood glucose control and the closure of tuberculosis cavity.
作者
李青
贾俊楠
安军
崔俊伟
李卫民
LI Qing;JIA Junnan;AN Jun;CUI Junwei;LI Weimin(Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China)
出处
《中国热带医学》
CAS
2018年第6期609-613,共5页
China Tropical Medicine
基金
北京市通州区科技计划项目(No.KJ2017CX046)
关键词
肺结核
糖尿病
二甲双胍
糖化血红蛋白
结核空洞
pulmonary tuberculosis
diabetes mellitus
metformin
glycosylated hemoglobin
tuberculosis cavity
