Study On The Correlation Between Ct Features And Glycosylated Hemoglobin Level In Patients With Diabetes Mellitus Complicated With Pulmonary Tuberculosis

Objective : To investigate the correlation between CT features and hemoglobin Glycosylated(Hb Alc) levels in patients with diabetes mellitus complicated with pulmonary tuberculosis.Materials and methods:180 cases of the untreated patients with Type 2 diabetes mellitus complicated with pulmonary tuberculosis were randomly selected from April 2012 to March 2015 in the Huai’an Infectious Disease Hospital. Bsaed on the results of glycosylated hemoglobin detection, and the 2013 version of Chinese type 2 diabetes prevention and treatment guidelines, the patients were divided into three groups: Hb Alc content<7% is good blood glucose controlled group(Group I, n=32), the level 7-9% is the general controlled group(Group II, n=48) and the level>9% is poor controlled group(Group III, n=100). The chest CT manifestations of the three groups were observed before treatment, the changes of CT manifestations and glycosylated hemoglobin were also analyzed after treatment. SPSS 19.0 statistical software was applied. Tthe presentation of data was`x±s, A one-way analysis of variance was used to the comparison among three groups. The enumeration data was indicated by percentage(%), c2-test was conducted for comparison between groups. The chi square test was used in the comparison group, linear trend chi square test was used for order group data, P<0.05 had statistical significance.Result: In the three groups, The detection rate of leaves large patchy shadows was 50%(16/32), 56.2%(27/48) and 87%(87/100), the air bronchogram sign detection rate was40.6%(13/32) respectively, 47.9%(23/48) and 77%(77/100), and the discovery rate of wormhole like empty was 31.2%(10/32) respectively, 45.8%(22/48), 65%(65/100),thick wall cavity detection rate was 25%(8/32), 31.2%(15/48), 52%(52/100), the rate of multiple hollow multiple was 34.3%(11/32), 50%(24/48), 73%(73/100), and bronchial tuberculosis was found in 33.3%(7/32), 21.8%(16/48), and 46%(46/100), respectively.The detection rates of lesions in Group III were significantly higher than Group II and Group I(P<0.05), and the rate of discovery was increased(P<0.05). Meanwhile, the average size of lesions in the three groups was increased with the increasing of the Hb Alc.After treatment, the patients’ Hb Alc reached control target(< 7%) among the three groups,their CT absorption improvement rates were 100%(32/32), 72.9%(35/48), 56%(56/100).The therapeutic efficacy of group I was better than group II(c2=10.35, P<0.01), and the treatment efficacy of group II was better than group III(c2=3.92, P<0.05). Three groups of tuberculosis improvement rate increased progressively(c2 trend =21.81, P< 0.05).Conclusion: CT manifestations of diabetes mellitus complicated with pulmonary tuberculosis were closely related to the level of glycosylated hemoglobin. If glycated hemoglobin standard < 7%, the effect of tuberculosis treatment is better. Glycosylated hemoglobin in a certain extent effectively reflect the severity and therapeutic effect of the disease;CT can provide some important information for clinical imaging;The above two examinations can guide clinician to timely formulate the appropriate diagnosis and treatment.