摘要
目的探究使用肺泡灌洗术联合甘精胰岛素(GL)、阿卡波糖治疗糖尿病(DM)合并肺部感染的疗效。方法将武警天津市总队医院120例DM合并肺部感染患者按随机数表法分为研究组60例与对照组60例,研究组接受肺泡灌洗术联合GL、阿卡波糖治疗,对照组仅接受GL和常规抗感染治疗,对比两组患者治疗前后血糖水平及治疗3 d后C-反应蛋白(CRP)、白细胞介素-8(IL-8)、降钙素原(PCT)水平,分析肺泡灌洗术联合GL、阿卡波糖治疗DM合并肺部感染的临床疗效。结果120例患者痰液标本共分离出病原菌160株,其中大肠埃希菌、阴沟肠杆菌、铜绿假单胞菌共占比73.75%;两组患者治疗前、空腹、餐后2 h血糖水平比较,无统计学差异;治疗后研究组空腹、餐后2 h血糖水平低于对照组(P<0.05)。研究组治疗3 d后CRP、IL-8、PCT的水平低于对照组(P<0.05)。治疗前两组患者急性生理与慢性健康评分(APACHE)Ⅱ评分、CD_(4)^(+)CD_(25)^(+)调节性T细胞水平比较,无统计学差异,治疗后研究组患者APACHEⅡ评分、CD_(4)^(+)CD_(25)^(+)调节性T细胞水平低于对照组(P<0.05)。结论肺泡灌洗术联合GL、阿卡波糖治疗DM合并肺部感染疗效确切且安全性较高,能有效改善患者临床症状及呼吸道炎症,改善患者血糖水平。
OBJECTIVE To explore the effect of alveolar lavage combined with glargine(GL)and acarbose on treatment of diabetes mellitus(DM)complicated with pulmonary infection.METHODS A total of 120 DM patients complicated with pulmonary infection who were treated in Tianjin General Hospital of Armed Police were randomly divided into the study group with 60 cases and the control group with 60 case.The study group was treated with alveolar lavage combined with GL and acarbose,while the control group was only given GL and conventional anti-infection therapy.The blood glucose level was compared between the two groups of patients before and after the treatment,the levels of C-reactive protein(CRP),interleukin-8(IL-8),and procalcitonin(PCT)were compared between the two groups of patients after the treatment for 3 days,and the clinical effect of alveolar lavage combined with GL and acarbose on treatment of DM complicated with pulmonary infection was observed.RESULTS Totally 160 strains of pathogens were isolated from sputum specimens of the 120 patients,73.75%of which were Escherichia coli,Enterobacter cloacae and Pseudomonas aeruginosa.There were no significant differences in the levels of fasting and 2 h postprandial blood glucose between the two groups of patients before the treatment;the levels of fasting and 2 h postprandial blood glucose of the study group were significantly lower than those of the control group after the treatment(P<0.05).The levels of CRP,IL-8 and PCT of the study group were significantly lower than those of the control group after the treatment for 3 days(P<0.05).There were no significant differences in Acute Physiology and Chronic Health Score(APACHE)Ⅱscore and CD_(4)^(+)CD_(25)^(+)regulatory T cells between the two groups of patients before the treatment;the APACHEⅡscore and CD_(4)^(+)CD_(25)^(+)regulatory T cells of the study group were significantly lower than those of the control group after the treatment(P<0.05).CONCLUSION The alveolar lavage combined with GL and acarbose is highly effective and
作者
王静
董铮
化幸存
王得顺
季淑艳
WANG Jing;DONG Zheng;HUA Xing-cun;WANG De-shun;JI Shu-yan(Tianjin Generat Hospital of Armed Police,Tianjin 300161,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第14期2114-2118,共5页
Chinese Journal of Nosocomiology
基金
天津市科技计划基金资助项目(16ZXHLSY00120)。
