2型糖尿病合并泌尿系感染的临床特征分析  

Clinical features of type 2 diabetes mellitus complicated by urinary tract infection

作　　者：张小云[1] ZHANG Xiaoyun(Department of Infectious Diseases,People’s Hospital of Langfang City,Hebei,Langfang 065000,China)

机构地区：[1]河北省廊坊市人民医院感染科,065000

出　　处：《河北医药》2018年第6期914-917,共4页Hebei Medical Journal

基　　金：河北省科学技术研究与发展支撑项目(编号:20142931)

摘　　要：目的探讨2型糖尿病合并泌尿系感染的临床特征与CT影像学表现。方法泌尿系感染患者180例,依据患者是否合并糖尿病分为糖尿病组(n=80)与非糖尿病组(n=100)。比较2组患者一般资料、临床特点与影像学特征。结果 2组患者性别比、年龄、体重指数、高血压病、冠心病、肾盂积水情况、发热比例等资料比较差异无统计学意义(P>0.05)。糖尿病组患者血清降钙素原(PCT)、白介素-6(IL-6)、肌钙蛋白(c Tn T)、血浆钠尿肽(BNP)水平升高,血小板计数下降,与非糖尿病组比较差异有统计学意义(P<0.05),但白细胞总数差异无统计学意义(P>0.05)。糖尿病组合并炎性反应综合征、严重脓毒症、脓毒症性休克、急性呼吸窘迫综合征、多脏器功能损伤比例高于非糖尿病组患者,差异均有统计学意义(P<0.05)。糖尿病组患者尿培养阳性率血细菌培养阳性率高于非糖尿病组,差异有统计学意义(P<0.05)。糖尿病组患者尿细菌培养结果前三位为埃希氏大肠杆菌、肺炎克雷伯杆菌、尿肠球菌,而非糖尿病组患者尿细菌培养结果前三位为埃希氏大肠杆菌、尿肠球菌、粪肠球菌。尿源性脓毒血症肾脏CT影像学示肾盂、输尿管扩张、肾盂内积气、肾周围筋膜增厚、后腹膜腔积液。糖尿病组患者抗生素使用时间、限制性抗生素应用比例、特殊性抗生素应用比例、住院时间、住院费用均高于非糖尿病组患者,差异均有统计学意义(P<0.05)。结论糖尿病合并泌尿系感染患者病情严重,合并尿源性脓毒血症患者比例增加,感染病原体中以肺炎克雷伯杆菌感染比例较高,临床治疗时间较长,费用较高。Objective To investigate the clinical features and CT imaging of type 2 diabetes mellitus complicated by urinary tract infection.Methods A total of 180 patients with urinary tract infection were divided into diabetes mellitus group(n=80)and non-diabetes group(n=100)according to whether the patients were complicated with diabetes mellitus.The general data,clinical features and imaging features of patients were compared between the two groups.Results There were no significant differences in gender,age,BMI,hypertension,coronary heart disease,hydronephrosis and fever rate between the two groups(P>0.05).The serum levels of procalcitonin(PCT),interleukin 6(IL-6),cardiac troponinI(CTNT),plasma natriuretic peptide(BNP)in diabetes mellitus group were increased,however platelet counts were significantly decreased,as compared with those in non-diabetes group(P<0.05),however,there were no significant differences in total white cell counts between two groups(P>0.05).The incidence rates of diabetes combined with inflammatory response syndrome,severe sepsis,septic shock,acute respiratory distress syndrome,multiple organ function damage in diabetes mellitus group were significantly higher than those in non-diabetes group(P<0.05).Moreover the urine culture positive rate and blood bacterial culture positive rate in diabetes mellitus group were significantly higher than those in non-diabetes group(P<0.05).The top three genus of urine bacterial culture in diabetes mellitus group were Escherichia coli(43.75%),Klebsiella pneumoniae(27.50%),Enterococcus faecium(16.25%),respectively,while the top three genus of urine bacterial culture in non-diabetes group were Escherichia coli(43.00%),Enterococcus faecium(28.00%),Enterococcus faecalis(19.00%),respectively.CT imaging showed renal pelvis and ureter dilatation,internal gas in the pelvis,thickening of the perirenal fascia and retroperitoneal peritoneal effusion.In addition the use time of antibiotics,application proportion of restrictive antibiotic and special antibiotics,hospital stay and

关 键 词：糖尿病 泌尿系感染 临床特征 CT成像 

分 类 号：R587.1[医药卫生—内分泌]