目的 研究2型糖尿病(T2DM)合并 肺结核(PTB)老年患者CT征象特点，为提 高临床诊断和治疗水平提供参考依据。方 法 选取2016年8月至2018年8月我院T2DM 合并PTB患者(观察组)和单纯PTB患者(对 照组)各80例为研究对象分别进行CT检 查，比较两组病变位置、累及范围、病灶 形态和性质等图像特点。结果 两组病灶 位置分布情况无明显差异(P>0.05)，观察 组双肺受累率及平均受累肺段数量高于对 照组，差异有统计学意义(P<0.05)；观察 组结节状病灶比例少于对照组，空洞、斑 片状影、胸腔积液及淋巴结肿大发生率及 空洞数量均高于对照组，差异有统计学意 义(P<0.05)。结论 T2DM合并PTB老年患者 CT征象与单纯PTB患者相比较存在明显差 异，除累及范围更广外，病灶形态也存在 较多变化，主要表现为多肺叶或肺段大面 积实变，伴渗出、干酪样变、空洞形成和 树芽征，且结节病灶大量减少。

Objective To study the CT signs features in elderly patients with type 2 diabetes mellitus (T2DM) complicated with pulmonary tuberculosis (PTB) so as to provide reference for improving clinical diagnosis and treatment. Methods Each 80 cases of patients with T2DM and PTB (observation group) and patients with simple PTB (control group) from August 2016 to August 2018 in our hospital were selected for the study and they were given CT examination. The image features of lesion location, involvement range and lesion morphology and nature were compared between the two groups. Results There was no significant difference in the lesion location between the two groups (P>0.05), and the double lung involvement rate and average number of affected lung segments in observation group were higher than those in control group (P<0.05). The proportion of nodular lesions in observation group was less than that in control group, and the incidence rates of cavitation, patchy shadows, pleural effusion and lymphadenopathy and the cavitation quantity were higher than those in control group(P<0.05). Conclusion CT signs of elderly patients with T2DM complicated with PTB are significantly different from those of patients with PTB. Except for a wider involvement range, there are more changes in the lesions morphology whose main manifestations are multi-lobes or large consolidation of lung segments, accompanied by exudation, caseation, cavitation formation and tree-inbud sign and greatly reduced nodular lesions.