国内糖尿病常见社区获得性感染及其危险因素的Meta分析  

Community-acquired infections and risk factors in patients with diabetes:A Meta-analysis

作　　者：赵广丹[1] 赵明静[1] 李方治[1] 王玲玲[1] 孙佳英[1] 陈东红[1] 王笑歌[1] 

机构地区：[1]中国医科大学附属第四医院,辽宁沈阳110032

出　　处：《中国感染控制杂志》2014年第10期577-583,共7页Chinese Journal of Infection Control

基　　金：国家十一五科技支撑项目(2007BAI24B004);辽宁省科技厅项目(20132253030);沈阳市科技局项目(F12-277-1-71)

摘　　要：目的采用循证医学系统分析方法分析国内糖尿病患者合并社区获得性感染的种类及其危险因素。方法计算机检索中国学术期刊网全文数据库（CNKI）、万方数据库、维普数据库,汇总国内发表的有关糖尿病合并社区获得性感染及危险因素的研究,应用stata 11.0软件进行Meta分析。结果共纳入12篇文献。糖尿病患者社区获得性感染率为22.12%-55.86%,平均39.55%。常见感染（感染发生率）为呼吸系统感染（40.74%）、泌尿系统感染（27.35%）、结核（10.80%）、皮肤黏膜感染（9.19%）、肝胆系统感染（5.57%）。按照纳入文献危险因素进行分层分析,结果显示,合并慢性并发症、年龄、病程、血糖控制情况、性别、糖尿病类型和酮症酸中毒各亚组合并OR及OR95%CI分别为1.63（1.45,1.82）、1.30（1.19,1.42）、1.47（1.35,1.61）、0.68（0.61,0.76）、0.69（0.64,0.75）、1.37（1.13,1.66）和0.87（0.62,1.23）。对各危险因素亚组发表偏倚和敏感性进行分析,结果显示,发表偏倚不明显,合并结果稳定性较好。结论国内糖尿病患者常见社区获得性感染依次为：呼吸系统感染、泌尿系统感染、结核、皮肤软组织感染等;女性、高龄、病程长、血糖控制不佳、有并发症均可导致糖尿病患者社区获得性感染的概率增加。Objective To analyze the types and risk factors of community-acquired infections（CAI）in diabetic patients by system analysis method of evidence-based medicine.Methods China National Knowledge Infrastructure（CNKI）,Wanfang database,VIP database were searched by computer,domestic published researches on CAI and related risk factors in diabetic patients were aggregated,Meta-analysis was conducted by stata 11.0software.Results A total of 12 literatures were included in the study.The average rate of CAI in diabetic patients was 39.55%（22.12%-55.86%）.The major infections were respiratory system infection（40.74%）,urinary tract infection（27.35%）,tuberculosis（10.80%）,skin and soft tissue infection（9.19%）,and hepatobiliary system infection（5.57%）.Stratified analysis on risk factors revealed that OR and OR95%CIof chronic complication,age,disease course,glycemic control,gender,type of diabetes,subtype of ketoacidosis was 1.63（1.45,1.82）,1.30（1.19,1.42）,1.47（1.35,1.61）,0.68（0.61,0.76）,0.69（0.64,0.75）,1.37（1.13,1.66）and 0.87（0.62,1.23）,respectively.There was no publication bias and combined results were stable.Conclusion The main CAI in diabetic patients are respiratory system infection,urinary tract infection,tuberculosis,skin and soft tissue infection,and so on;several factors,such as female,older age,long-term disease course,poor glycemic control,and complication,can contribute to the increase of CAI in diabetic patients.

关 键 词：糖尿病 感染 社区感染 危险因素 META分析 

分 类 号：R587.1[医药卫生—内分泌]