肺結核と糖尿病 : 国療中央共同研究班

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As part of a joint study on cases of pulmonary tuberculosis combined with diabetes mellitus conducted at national sanatoria, bacteriological research was carried out. The data obtained from 820 cases of pulmonary tuberculosis with positive sputum and complicated with diabetes mellitus were collected and the results were summarized as follows; 1) Ratio of male to female was 3.7 (male) to 1 (female). 2) 75.7 percent of the patients were over 40 years of age. 3) Pulmonary tuberculosis was diagnosed prior to the discovery of diabetes mellitus in 584 cases (71.2%). In 116 cases (14.2%) pulmonary tuberculosis and diabetes mellitus were diagnosed simultaneously, and diabetes mellitus preceded in 120 cases (14.6%). 4) Patients were divided into two groups according to the degree of control of the diabetes: one group was well controlled and the other was not. Bacillary conversion rate was compared between the two groups: the negative conversion rate was 83% in the well controlled group and 28.9% in the other group. 5) The negative conversion rates among the well controlled group were 58.1% for patients treated with SM, 58.6% with PAS, 60.4% with INH, 58.8% with KM, 70.8% with CS, 77.0% with EB, 80.0% with VM and CPM. 6) The negative conversion rate among the originally treated cases was 86.4% in the group of good diabetes control and 43.5% in the other. 7) Among the patients whose diseases were discovered simultaneously, the negative conversion rate was 87.3% in the well controlled group and was 76.7% in cases with diabetes mellitus preceded pulmonary tuberculosis. 8) Drug resistant bacilli. emerged after six months treatment in 14.1% of the cases in which diabetes mellitus preceded and in 8.8% of the cases in which both diseases were diagnosed at the same time. 9) The clinical effect of ethambutol was considerably good for pulmonary tuberculosis when the diabetes mellitus was well controlled. The negative conversion rate was 59.4% in all cases. Unfaborable side effects were seen in 1.8% of the cases and it was not higher than that of non-diabetic pulmonary tuberculous patients. Good control of diabetes mellitus is essential for the treatment of pulmonary tuberculosis. When adequate treatment is given to pulmonary tuberculosis patients who are combined with diabetes mellitus, the clinical effects would be similar to those for non-diabetic pulmonary tuberculosis patients, but higher emergence of drug resistance against anti-tuberculous drugs might be seen in cases with poorly controlled diabetes mellitus.
日本結核病学会の論文

肺結核と糖尿病 : 国療中央共同研究班

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