2型糖尿病患者肺部感染病原菌特征及其与炎症因子、肺功能变化的相关性分析  

Characteristics of pathogens causing pulmonary infection in patients with type 2 diabetes mellitus and its correlation with inflammatory factors and pulmonary function

作　　者：杜伟鹏[1] 汪海霞[1] 徐曼[1] DU Wei-peng;WANG Hai-xia;XU Man(Department of Laboratory Medicine,Nanyang Central Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市中心医院检验科,河南南阳473000

出　　处：《中国病原生物学杂志》2021年第1期90-93,共4页Journal of Pathogen Biology

摘　　要：目的分析2型糖尿病患者肺部感染病原菌特征及其与炎症因子、肺功能变化的相关性。方法选取2017年3月-2018年3月本院收治的2型糖尿病合并肺部感染患者(感染组)98例,同期收治的单纯性2型糖尿病患者(非感染组)92例,健康志愿者100例(对照组)。采集感染组患者的痰液标本,检测肺部感染病原菌种类及分布特征,并进行药敏试验。采集所有受试者血液标本,采用ELISA检测血清炎症因子超敏C-反应蛋白(hs-CRP)、白介素1β(IL-1β)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,采用肺功能仪检测肺功能指标。结果98例2型糖尿病合并肺部感染患者共分离出128株病原菌,其中革兰阴性菌70株(54.69%),革兰阳性菌46株(35.94%),真菌12株(9.66%)。其中,大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌占比均>10%。大肠埃希菌对头孢噻肟、阿莫西林、红霉素的耐药率>80%,金黄色葡萄球菌对阿莫西林、红霉素的耐药率>80%,肺炎克雷伯菌对9种受试抗生素的耐药率均<80%。4组受试者比较hs-CRP、IL-1β、IL-6、TNF-α水平差异均有统计学意义(均P<0.01),其中真菌感染组hs-CRP高于其他3组(P<0.05);细菌感染组与真菌感染组比较IL-1β、IL-6、TNF-α水平差异均无统计学意义(均P>0.05),但均高于对照组和非感染组(P<0.05)。4组受试者的FEV1百分率、FEV1/FVC值及PEF水平差异均有统计学意义(均P<0.01),其中感染组上述指标均高于对照组和非感染组(均P<0.05)。结论2型糖尿病患者肺部感染的病原菌主要为革兰阴性菌,各类病原菌对常用抗菌药物均有不同程度的耐药性,且肺部病原菌感染可加重机体炎症反应,降低患者肺功能。Objective To analyze the characteristics of pathogens causing a pulmonary infection in patients with type 2 diabetes mellitus and its correlation with inflammatory factors and pulmonary function.Methods Subjects were 98 patients with type 2 diabetes and a pulmonary infection(patients with an infection)seen at this Hospital from March 2017 to March 2018,92 patients with simple type 2 diabetes mellitus seen during the same period(patients without an infection),and 100 healthy volunteers(control group).Sputum samples from patients with an infection were collected to detect the types and distribution characteristics of pathogens causing a pulmonary infection,and a drug sensitivity test was performed.Blood samples were collected from all subjects.The levels of serum inflammatory factors(hs CRP,IL-1β,IL-6,and TNF-α)were detected using ELISA,and lung function indices were determined using a pulmonary function analyzer.Results One hundred and twenty-eight strains of pathogens were isolated from 98 patients with type 2 diabetes mellitus and a pulmonary infection,including 70 strains of Gram-negative bacteria(54.69%),46 strains of Gram-positive bacteria(35.94%),and 12 strains of fungi(9.66%).Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,and Acinetobacter baumannii accounted for more than 10%of the pathogens isolated.The resistance of Escherichia coli to cefotaxime,amoxicillin,and erythromycin was higher than 80%.The resistance of Staphylococcus aureus to amoxicillin and erythromycin was higher than 80%.The resistance of Klebsiella pneumoniae to all antibiotics was lower than 80%.The levels of hs-CRP,IL-1β,IL-6,and TNF-αdiffered significantly among the four groups of subjects(P<0.01 for all),and the hs-CRP level was higher in patients with a fungal infection than in the other three groups(P<0.05).There were no significant differences in the levels of IL-1β,IL-6,and TNF-αin patients with a bacterial infection and patients with a fungal infection(P>0.05 for all),but the levels were all higher than those i

关 键 词：2型糖尿病 肺部感染 病原菌 炎症因子 肺功能 

分 类 号：R378[医药卫生—病原生物学]