糖尿病合併肺結核の治療成績
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We investigated 127 patients of culture-positive pulmonary tuberculosis complicated with diabetes mellitus (92 cases of initial treatment and 35 cases of retreatment) who were admitted to our hospital during the period from 1977 to 1983, and then obtained the following results:<BR>1. The initial treatment group of tuberculosis with diabetes was predominant in terms of older ages, highly positive cultures and extensive lesions demonstrated roentgenographi callv, when compared with the similar group without complicating diabetes as control.<BR>2. In all the 88 patients of tuberculosis with diabetes who were treated initially with combination regimens including INH and RFP known to be susceptible, sputum cultures converted to negative within 4 months irrespective of good or poor control of complicating diabetes, and thereafter no bacteriological relapse was observed by follow-up study.<BR>3. The retreated diabetic group consisted of a considerable number of advanced patients who expectorated organisms resistant to multiple drugs and showed a poor clinical response to treatments.<BR>However, in 19 cases having susceptibility to INH and RFP, negative smears and cultures were eventually attained independently of the severity of tuberculous lesions as well as the efficiency of control of diabetes, and a bacteriological relapse was found in only a single case by follow-up.<BR>4. The cases treated with regimens excluding INH and RFP (4 cases of initial treatment and 16 cases of retreatment) showed an extremely poor response to the chemotherapy.<BR>5. Although the effectiveness of chemotherapy with regimens including INH and RFP which had been confirmed to be susceptible was very satisfactory suitable duration of chemotherapy has to be studied further.
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