Analysis Of Clinical Characteristics Of Active Tuberculosis With Type-2 Diabetes Mellitus

Objective: To investigate that the clinical characteristics of active TB with type-2 diabetes mellitus patients and what factors influence the sputum negative conversion after two-month intensive treatment.Methods: The research was a retrospective study. 135 TB patients from The Yijishan Hospital of Wannan Medical College between July 2012 and July 2014 was enrolled in the study(Group I:45 patients were diagnosed as having tuberculosis with type 2 diabetes mellitus;Group II: the remaining 90 patients had tuberculosis without type 2 diabetes mellitus).All eligible patients with complete clinical data. Statistical analysis of the clinical characteristics of active TB with type-2 diabetes mellitus patients and what factors influence the sputum negative conversion after two-month intensive treatment.Results: The sputum-positive of Group I was significantly higher than Group II. The incidence of the cheese exudative lesions of Group I was significantly higher than Group II(χ2=12.660, P<0.001). But the incidence of its fibrous proliferative lesions were significantly lower than Group II(χ2=14.181, P<0.001). Calcified lesions between the two groups showed no significant difference(χ2=0.066, P=0.797). There was no significant difference in the incidence of single cavitary between Group I and Group II(χ2=0.840, P=0.772). However, the incidence of multiple cavitary for TB patients with diabetes was higher than Group II(χ2=10.385, P=0.001). The Incidence of the wormhole cavitary and the fibrous cavitary between the two groups showed no significant difference(χ2=1.960, P=0.162;P=0.495). But the proportion of Group I occur cheese cavitary significantly higher than Group II(χ2=8.477, P=0.004). Spearman rank correlation analysis showed that diabetes was correlated with cavitary lesions(γ=0.227, P=0.008) and sputum positive(γ=0.216, P=0.012). Further analysis showed that the incidence cavitary lesion of patients with poor glycemic control than those with good glycemic control was higher(χ2=3.900, P=0.048). Logistic regression models showed that the odds ratio of diabetes mellitus was 2.295(95% CI 1.199-9.387, P = 0.0123) in the anti-TB treatment, but the odds ratio of cavitary lesion was 6.036(95% CI 3.014-11.938, P <0.001), suggesting that cavitary lesions applying a higher impact the patient’s sputum negative rate than the impact of diabetes.Conclusion: TB patients with type-2 diabetes mellitus had severe clinical symptoms than tuberculosis patients. Diabetes mellitus and lung cavity formation influence the putumnegative conversion. The presence of lung cavities was found to be a more important determinant of the treatment outcomes than that of diabetes in patients with pulmonary tuberculosis.