【摘要】 目的：探討贝达喹啉对糖尿病伴耐药肺结核患者痰菌转阴及血糖控制情况的影响。方法：回顾性分析2017年1月-2018年1月本院174例糖尿病合并肺结核患者的临床资料，根据治疗方法分为常规治疗组（n=42）和联合治疗组（n=132）。常规治疗组采用常规治疗，联合治疗组在常规治疗组的基础上加用贝达喹啉。比较两组痰菌转阴率及血糖控制情况。结果：联合治疗组转阴率为74.24%（98/132），高于常规治疗组的50.00%（21/42），差异有统计学意义（P<0.05）。治疗前，两组FPG、2 h PG及HbA1c水平比较，差异均无统计学意义（P>0.05）;治疗后，联合治疗组FPG、2 h PG及HbA1c水平均低于常规治疗组，差异均有统计学意义（P<0.05）。结论：贝达喹啉用于糖尿病患者合并耐药肺结核患者中，有助于提高痰菌转阴率，能更好地控制患者血糖水平，值得推广应用。

【关键词】 糖尿病 耐药肺结核 贝达喹啉 痰菌转阴 血糖控制

Effect of Bedaquinoline on Sputum Negative Conversion and Blood Glucose Control in Diabetic Patients with Drug-Resistant Pulmonary Tuberculosis/LIU Xianwei. //Medical Innovation of China， 2021， 18（34）： -153

[Abstract] Objective： To investigate the effect of Bedaquinoline on sputum negative conversion and blood glucose control in diabetic patients with drug-resistant pulmonary tuberculosis. Method： The clinical data of 174 patients with diabetes and drug-resistant pulmonary tuberculosis in our hospital from January 2017 to January 2018 were retrospectively analyzed. They were divided into conventional treatment group （n=42） and combination treatment group （n=132） according to the treatment methods. The conventional treatment group was treated with conventional treatment， and the combined treatment group was treated with Bedaquinoline on the basis of the conventional treatment group. The negative rate of sputum bacteria and blood glucose control were compared between two groups. Result： The sputum negative conversion rate in the combined treatment group was 74.24% （98/132）， which was higher than 50.00% （21/42） in the conventional treatment group， the difference was statistically significant （P<0.05）. Before treatment， there were no significant differences in the levels of FPG， 2 h PG and HbA1c between two groups （P>0.05）; after treatment， the levels of FPG， 2 h PG and HbA1c in the combined treatment group were lower than those in the conventional treatment group， and the differences were statistically significant （P<0.05）. Conclusion： Bedaquinoline used in diabetic patients with drug-resistant pulmonary tuberculosis can help increase the rate of sputum negative conversion， and can better control the patient’s blood sugar level， which is worthy of popularization and application.

[Key words] Diabetes Drug-resistant pulmonary tuberculosis Bedaquinoline Sputum negative conversion Blood glucose control

First-author’s address： Dalian Tuberculosis Hospital， Dalian 116033， China

doi：10.3969/j.issn.1674-4985.2021.34.036

糖尿病是一种全身慢性疾病，临床以高血糖为主要特征[1]。目前，临床上对于糖尿病发病机制尚未阐明，普遍认为与遗传、环境等因素有关，临床表现以多饮、多尿、体重减轻为主，且随着患者病程的延长，将会引起神经、心脏慢性损害及功能障碍[2]。而肺结核是由结核分枝杆菌引起的慢性传染病，能侵及诸多脏器，且临床以肺部结核感染多见[3-4]。但是，人体感染肺结核菌后不一定发病，仅当机体抵抗力降低或细胞介导的变态反应增高时发病[5]。目前，肺结核与糖尿病均成为重大的公共卫生问题。《2018年全球结核病报告》中指出，2017年新发结核病例达1 000万，约157万人因结核病死亡[6]。……