摘要
目的分析糖尿病肾病(DN)患者肺部感染的病原菌分布及危险因素,为糖尿病肾病患者肺部感染的管理及预防提供理论依据。方法选取2018年3月至2020年12月来海南省三亚中心医院进行治疗的DN患者486例,根据是否发生肺部感染分为实验组(肺部感染,n=178)和对照组(未发生肺部感染,n=308),分析所有患者痰培养结果,收集两组患者年龄、性别、住院时间、血糖水平、肾功能指标等资料,采用logistic回归分析DN患者生肺部感染的独立危险因素。结果研究共纳入DN患者发生肺部感染178例,其中共检出142株病原菌,其中革兰氏阴性菌共91株(64.08%),主要是以肺炎克雷伯菌39株(27.46%)、铜绿假单胞菌28株(19.72%)、鲍曼不动杆菌18株(12.68%)为主;革兰氏阴性菌共43株(30.28%),主要是金黄色葡萄球菌32株(22.54%);真菌共8株(5.63%);两组患者在年龄、COPD病史、住院时间、糖化血红蛋白、血清白蛋白、容量负荷过多、尿毒症、营养不良间差异有统计学意义(P<0.05);多因素logistic回归分析结果显示COPD病史、HbA1c、容量负荷过多、血清白蛋白、尿毒症、营养不良是DN合并肺部感染的相关因素(P<0.05)。结论DN患者易发生肺部感染,主要病原菌为肺炎克雷伯菌、黄金葡萄球菌、铜绿假单胞菌等,主要危险因素为COPD病史、HbA1c、容量负荷过多、血清白蛋白、尿毒症、营养不良,应该补充营养,控制血糖,延缓器官功能衰退,提高机体免疫力等预防DN患者发生肺部感染。
Objective To analyze the distribution of pathogenic bacteria and risk factors of pulmonary infection in patients with diabetic nephropathy(DN),and to provide a theoretical basis for the management and prevention of pulmonary infection in DN patients.Methods A total of 486 DN patients treated in our hospital from March 2018 to December 2020 were selected and divided into experimental group(pulmonary infection,n=178)and control group(no pulmonary infection,n=308)according to the occurrence of pulmonary infection.Sputum samples from all patients were cultured and analyzed.The data of age,gender,length of hospital stay,blood glucose level and renal function indexes of patients in the two groups were collected.Logistic regression was used to analyze the independent risk factors of pulmonary infection in DN patients.Results A total of 178 cases of pulmonary infection in DN patients were included in this study,among which 142 strains of pathogenic bacteria were detected,including 91 strains(64.08%)of gram-negative bacteria,43 strains(30.28%)of gram-positive bacteria,and 8 strains of fungi(5.63%).The gram-negative bacteria mainly consisted of 39 strains(27.46%)of Klebsiella pneumoniae,28 strains(19.72%)of Pseudomonas aeruginosa and 18 strains(12.68%)of Acinetobacter baumannii.The gram-positive bacteria included mainly 32 strains(22.54%)of Staphylococcus aureus.There were statistically significant differences between the two groups in age,COPD history,length of hospital stay,HBA1c,serum albumin,volume overload,uremia,and malnutrition(P<0.05).Multivariate logistic regression analysis showed that COPD history,HbA1c,volume overload,serum albumin,uremia and malnutrition were the influencing factors of DN combined with pulmonary infection(P<0.05).Conclusion DN patients are prone to pulmonary infection,and the main pathogens are Klebsiella pneumoniae,Staphylococcus aureus,and Pseudomonas aeruginosa.The main risk factors are COPD history,HbA1c,volume overload,serum albumin,uremia,and malnutrition.It is recommended to supplement
作者
陈铅琴
侯涛
CHEN Qian-qin;HOU Tao(Department of Endocrinology,Sanya Central Hospital,Sanya,Hainan 572000,China;Cancer Center of Xiangya Second Hospital of Central South University Changsha,Changsha,Hunan 410126,China)
出处
《公共卫生与预防医学》
2022年第2期137-139,共3页
Journal of Public Health and Preventive Medicine
基金
海南省卫生计划生育委员会项目(1601320114A2002)。
关键词
糖尿病肾病
肺部感染
病原菌分布
危险因素
Diabetic nephropathy
Lung infection
Distribution of pathogenic bacteria
Risk factors
