社区老年2型糖尿病患者尿路感染的影响因素分析  

Analysis of influencing factors of urinary tract infections in community elderly patients with type 2 diabetes mellitus

作　　者：张珊 徐巨梁 陈海英 周瑛 陈培红 金华 于雪梅 

机构地区：[1]上海市奉贤区中心医院内分泌代谢科,201400 [2]上海市奉贤区齐贤社区卫生服务中心 [3]上海市奉贤区西渡社区卫生服务中心 [4]上海市奉贤区青村镇社区卫生服务中心

出　　处：《中国全科医学》2017年第A02期23-26,共4页Chinese General Practice

基　　金：上海市科学技术委员会医学引导项目(134119b2500);上海申康医院发展中心(SHDC12012302)

摘　　要：目的探讨社区老年2型糖尿病(T2DM)患者尿路感染的影响因素。方法选取2014年8月—2015年8月于上海市奉贤区中心医院收治的老年T2DM患者563例,根据有无尿路感染分为感染组(n=51)和未感染组(n=512)。测定比较两组患者性别、年龄、糖尿病病程、体质指数(BMI)、腰围、臀围、收缩压、舒张压、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))及糖尿病周围神经病变(DPN)、糖尿病肾病(DN)、糖尿病视网膜病变(DR)、糖尿病下肢动脉粥样硬化性病变(LEAD),并分析社区老年T2DM患者尿路感染的影响因素。结果两组患者年龄、糖尿病病程、BMI、腰围、臀围、收缩压、舒张压、FPG、HbA_(1c)及DPN、DN、LEAD所占比例比较,差异无统计学意义(P>0.05);感染组患者女性、DR所占比例高于未感染组(P<0.05)。经多因素Logistic回归分析结果显示,女性[OR=4.032,95%CI(1.860,9.626)]、DR[OR=2.564,95%CI(1.284,5.076)]是影响T2DM患者尿路感染的独立危险因素(P<0.05)。结论女性、DR是老年T2DM患者尿路感染的独立危险因素,DR可作为T2DM患者尿路感染的预测因素。Objective To investigate the influencing factors of urinary tract infections in community elderly patients with type 2 diabetes mellitus（ T2DM）. Methods A total of 563 cases of elderly patients with T2 DM were selected from August2014 to August 2015 in Fengxian District Central Hospital of Shanghai,which were divided into infection group（ n = 51） and non-infection group（ n = 512） according to weather or not urinary tract infection. The genders,ages,diabetic duration,body mass index（ BMI）,waist and hip circumference,systolic blood pressure,diastolic blood pressure,fasting plasma glucose（ FPG）,Hb A1 cand diabetic peripheral neuropathy（ DPN）,diabetic nephropathy（ DN）,diabetic retinopathy（ DR）,lower extremity atherosclerotic disease（ LEAD） were determined and compared between the two groups,and the influencing factors of urinary tract infections in community elderly patients with T2 DM were analysed. Results No significant differences of ages,diabetic duration,BMI,waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, FPG, Hb A1 cor DPN,DN,LEAD was found between the two groups（ P 〉 0. 05）,the infection group of the prevalence of women and DR were higher than control group（ P 〈 0. 05）. Logistic regression analysis showed that women [OR = 4. 032,95% CI（ 1. 860,9. 626） ] and DR [OR = 2. 564,95% CI（ 1. 284,5. 076） ]were independent risk factors of urinary tract infections in T2 DM patients（ P 〈 0. 05）. Conclusion Women and DR are independent risk factors of urinary tract infections in T2 DM patients,and DR might be treated as the predictor of urinary tract infections in patients with T2 DM.

关 键 词：糖尿病 2型 尿路感染 糖尿病视网膜病变 糖尿病肾病 糖尿病性周围神经病变 糖尿病下肢动脉粥样硬化性病变 

分 类 号：R587.1[医药卫生—内分泌]