老年糖尿病患者下呼吸道感染的临床特点与危险因素  

Clinical characteristics and risk factors for lower respiratory tract infections in elderly patients with diabetic mellitus

作　　者：王兴珍[1] 李佳霖[1] 林仿[1] 励丽[1] 褚建平[1] 

机构地区：[1]宁波市第一医院内分泌科,浙江宁波315010

出　　处：《中华医院感染学杂志》2016年第9期1976-1978,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅科技基金资助项目(2002B050)

摘　　要：目的分析老年糖尿病患者下呼吸道感染的临床特点及危险因素,为临床诊断和治疗提供依据。方法选取2013年5月-2015年5月医院内分泌科收治的1 000例患者作为研究对象,对感染患者进行病原学和临床特点分析,比较不同患者的感染率,并对危险因素进行分析,采用SPSS16.0软件对数据进行统计分析。结果 1 000例患者中108例发生感染,感染率为10.80%;共分离出124株病原菌,以革兰阴性菌为主,占73.39%;108例感染患者中29例患者表现为不典型的临床症状,占26.85%,患者以多肺叶受累和双侧受累为主,分别占75.93%和71.30%,部分患者预后不良;年龄>75岁、糖化血红蛋白>7.0%、血红蛋白<90g/L、有合并症和侵入性操作与感染的发生具有相关性(P<0.05)。结论老年糖尿病合并下呼吸道感染的患者具有病原学复杂、临床表现不典型、受累范围大和预后不良的特点,临床上应对高危患者的诊断和治疗给予重视。OBJECTIVE To investigate the clinical characteristics of lower respiratory tract infections in elderly patients with diabetic mellitus and analyze the risk factors so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 1 000 patients who were treated in the department of endocrinology from May 2013 to May 2015 were recruited as the study objects,then the etiological and clinical characteristics of the patients with infections were analyzed,the infection rates were compared among the patients,the risk factors for the infections were observed,and the statistical analysis of data was performed with the use of SPSS16.0software.RESULTS Of the 1 000 patients,108had infections,with the infection rate 10.80%.Totally 124 strains of pathogens were isolated,of which 73.39% were gram-negative bacteria.Of the 108 patients with infections,29（26.85%）showed atypical clinical symptoms,of whom 75.93% had multi-lobe infection and 71.30% had bilateral infection;some patients had poor prognosis.The incidence of the infections was remarkably associated with the more than 75 years of age,level of glycosylated hemoglobin,level of hemoglobin less than 90g/L,complications,and invasive operations（P〈0.05）.CONCLUSION The elderly diabetes patients complicated with lower respiratory tract infections are characterized by the complex etiology,atypical clinical manifestations,large scope of involvement,and poor prognosis.It is necessary for the hospital to pay attention to the diagnosis and treatment of the high-risk patients.

关 键 词：糖尿病 下呼吸道感染 临床特点 危险因素 

分 类 号：R587.1[医药卫生—内分泌]