Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Clinical and Radiology Characteristics of Diabetic or Non-diabetic Tuberculosis Patients: a Retrospective Study

당뇨병 환자와 정상 혈당 환자에서 폐결핵의 임상적, 방사선학적 차이

  • Park, Hyung Wook (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Do, Kyong Rock (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Jeon, Eun Kyoung (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Park, Jin Young (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Ja Young (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Ji Eun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Park, Young Kun (Department of Internal Medicine, Cheongju St. Mary's Hospital) ;
  • Lee, Sang Rok (Department of Internal Medicine, Cheongju St. Mary's Hospital) ;
  • An, Jin Young (Department of Internal Medicine, Cheongju St. Mary's Hospital)
  • 박형욱 (가톨릭대학교 의과대학 내과학교실) ;
  • 도경록 (가톨릭대학교 의과대학 내과학교실) ;
  • 전은경 (가톨릭대학교 의과대학 내과학교실) ;
  • 박진영 (가톨릭대학교 의과대학 내과학교실) ;
  • 이자영 (가톨릭대학교 의과대학 내과학교실) ;
  • 김지은 (가톨릭대학교 의과대학 내과학교실) ;
  • 박용근 (청주성모병원 내과) ;
  • 이상록 (청주성모병원 내과) ;
  • 안진영 (청주성모병원 내과)
  • Received : 2008.02.12
  • Accepted : 2008.04.16
  • Published : 2008.04.30
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Abstract

Background: Patients with diabetes mellitus are highly sensitive to infections, including tuberculosis, and the longer the duration of DM, the greater is the prevalance of tuberculosis. We studied the difference of the clinical manifestations, radiologic findings, resistance and others factors of patients with diabetic and non-diabetic pulmonary tuberculosis. Methods: The patients we enrolled in this study were newly diagnosed with pulmonary tuberculosis from January 2003 to December 2005. Results: 159 patients were enrolled in this study. There were 30 pulmonary tuberculosis patients with diabetic mellitus (DMTB) and 129 pulmonary tuberculosis patients without diabetic mellitus (non-DMTB). There was no difference in the basic characteristics and clinical manifestation between both the groups. For the chest X-ray findings, the moderately advanced tuberculosis patients were the most common (43.3% in the DMTB group and 49.6% in the non-DMTB group). There was no relation between the severity of tuberculosis activity on chest x-ray and the presence of diabetes. The prevalence of cavitory lesions in the DMTB group was significantly higher than that in the non-DMTB group, but the prevalence of atelectasis was higher in the non-DMTB group (p<0.05). There was no difference in the incidence of lower lung involvement, the number of involved lobes, the number of treatment days and the radiological sequelae in both groups. Conclusion: The DMTB patients had a higher incidence of cavitory lesions and a higher incidence of atelectasis than the non-DMTB patients.

연구배경: 당뇨병 환자는 결핵을 비롯한 감염에 일반인들에 비해서 더 민감하고 당뇨병의 유병기간이 길수록 결핵 유병률이 높은 것으로 알려져 있다. 당뇨병 환자와 정상 혈당을 가진 폐결핵 환자들에서 임상 양상 및 방사선학적 차이및 결핵약제의 내성정도에 대한 임상의들의 많은 관심 및 연구가 이루어져왔고 이에 차이점 유무에 대해서 조사를 하였다. 방법: 203년 1월부터 205년 12월까지 청주 성모병원에 내원한 환자 중 객담 도말 양성이나 배양 양성 조직학적으로 폐결핵으로 진단된 159명의 환자를 대상으로 하였다. 결과: 당뇨병을 동반한 폐결핵 환자는 30명이었고 정상 혈당 폐결핵 환자는 129명이었다. 양 군의 기초적 특성 및 임상 양상에서 차이점은 없었다. 흉부 사진에서 증등도로 진행된 환자들이 가장 흔하였으나 당뇨병 유무와 결핵 중증도와는 관계가 없었다. 당뇨병이 있는 폐결핵 환자군 에서는 정상 혈당 폐결핵 환자 군에 비해 통계적으로 의미 있게 공동이 더 많이 있었으나 공동의 수나 크기는 차이가 없었다. 한편 무기폐는 정상 혈당 폐결핵 환자 군에서 더 많이 발생하였다. 그 이외에 하엽 침범 유무, 침범된 폐엽 수, 치료 기간에 차이가 없었다. 결론: 당뇨병을 동반한 폐결핵 환자는 공동을 더 많이 동반하였고 무기폐는 의미 있게 적게 발생하였다.

Keywords

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