糖尿病患者医院感染肺结核的早期诊断指标分析  

Early Diagnosis of Nosocomial Infection Caused by Pulmonary Tuberculosis in Patients with Diabetes Mellitus

作　　者：张常然[1] 牛媛媛[1] 黄知敏[2] 林建聪[1] 谭清华[1] 邢艳利[1] 李延兵[2] 刘霞[1] 李鸣[1] 

机构地区：[1]中山大学附属第一医院黄埔院区,广东广州510700 [2]中山大学附属第一医院内分泌科,广东广州510700

出　　处：《中华医院感染学杂志》2009年第22期3049-3051,共3页Chinese Journal of Nosocomiology

摘　　要：目的减少肺结核的医院感染,研究有助于糖尿病合并活动型肺结核的早期诊断指标。方法回顾分析某三甲医院内分泌科10年糖尿病合并活动型和非活动型肺结核316例患者的临床资料。结果活动型和非活动型肺结核组的平均年龄分别为(55.01±12.77)岁和(61.92±11.18)岁;非活动型肺结核多有肺结核病史(22.6%),明显多于活动型肺结核组患者(13.4%)(P<0.05);活动型和非活动型肺结核患者咳嗽、咳痰症状、痰涂片找分枝杆菌的阳性率分别为48.4%、80.0%,25.2%、10.0%;活动型和非活动型肺结核组的糖化血红蛋白(GHBA1c)、C肽、空腹血糖分别为(10.74±2.95)%(、0.56±0.38)nmol/L(、13.11±5.63)mmol/L(、8.68±2.08)%(、0.66±0.48)nmol/L、(10.33±9.41)mmol/L,上述指标两组相比,差异均有统计学意义(P<0.05)。结论出现咳嗽、咳痰症状、痰涂片找分枝杆菌、无明显诱因的血糖控制差等指标有助于糖尿病合并活动型肺结核的早期诊断,尽早检查这些指标,及时隔离,可减少肺结核的医院感染。OBJECTIVE To reduce the nosocomial infection caused by Mycobacterium tuberculosis in patients with diabetes mellitus, and study the some characteristics for early diagnosis of nosocomial infection. METHODS The clinical data of a total of 316 diabetes mellitus patients with pulmonary tuberculosis from Jan 1998 to Dec 2007 were made a retrospectively investigation. RESULTS The age was （55.01±12.77） and （61.92±11.18） years old in the patients with active and inactive pulmonary tuberculosis, respectively. The pulmonary tuberculosis history was more frequent in the patients with inactive pulmonary tuberculosis （22. 6%） than those with active one （13.4 %）. There was significant difference for pulmonary tuberculosis history between two groups （P〈0.05）. The frequency of cough with profuse sputum and the sputum positive rate with M. tubereulosis were 48.4 % and 80.0%vs 25.2% and 10.0% between two groups. The GHBAlc, C peptide and the control of blood glucose level were （10.74±2.95）H, （0. 56±0.38）nmol/L, and （13.11±5.63）mmol/L vs （8.68±2.08）%, （0. 66±0. 48） nmol/L and （10.33±9.41）mmol/L in the patients with active and inactive pulmonary tuberculosis, respectively. There were significant differences for these markers between the two groups （P〈0.05）. CONCLUSIONS These clinical manifestations with frequent cough and profuse sputum, the sputum positive with M. tuberculosis and surveillance of blood glucose level are helpful to early diagnosis of pulmonary tuberculosis in the patients with diabetes mellitus. It is very important to screen the indexes for reducing the nosocomial infection caused by M. tubereulosis.

关 键 词：医院感染 肺结核 糖尿病 调查 

分 类 号：R521[医药卫生—内科学]