糖尿病足合并冠心病病原菌检出及其长期生存状况  

Distribution of pathogens and long-term survival status of diabetic foot patients complicated with coronary heart disease

作　　者：李沛玲[1] 刘丹妮[1] LI Pei-ling;LIU Dan-ni(People's Hospital of Ningria Hui Autonomous Region,Yinchuan,Ningria 750o00,China)

机构地区：[1]宁夏回族自治区人民医院老年病科,宁夏银川750000

出　　处：《中华医院感染学杂志》2022年第1期51-55,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81860056);宁夏回族自治区自然科学基金资助项目(2020AAC03350)。

摘　　要：目的 分析不同细菌感染糖尿病足合并冠心病患者的长期生存状况。方法 回顾性分析2016年12月-2020年12月宁夏回族自治区人民医院收治的348例糖尿病足合并冠心病患者的临床资料。分析感染病原菌分布,比较不同细菌感染患者的感染程度和随访3年内的病情结局。结果 348例患者病足溃疡标本共分离出454株病原菌,其中261例(75.00%)为单一感染,常见感染病原菌为金黄色葡萄球菌、粪肠球菌、大肠埃希菌、铜绿假单胞菌。金黄色葡萄球菌、粪肠球菌、大肠埃希菌、铜绿假单胞菌单一感染患者Wagner分级中3级及以上的占比分别为49.02%、86.84%、73.68%、83.87%,粪肠球菌、铜绿假单胞菌单一感染患者的感染程度较重,金黄色葡萄球菌单一感染患者的感染程度较轻。随访3年,金黄色葡萄球菌单一感染患者的溃疡愈合率最高,其小截肢、大截肢、心脏事件和病死率相对较低;大肠埃希菌患者的溃疡愈合率最低、患者病死率相对较高。结论 粪肠球菌、铜绿假单胞菌感染糖尿病足合并冠心病患者的感染程度较重;金黄色葡萄球菌感染程度较轻,患者3年内溃疡愈合率最高,病死率最低;大肠埃希菌患者3年内溃疡愈合率最低,2年内病死率最高。OBJECTIVE To observe the long-term survival status of the diabetic foot patients complicated with heart disease. METHODS The clinical data of 348 diabetic foot patients complicated with coronary heart disease who were treated in the People′s Hospital of Ningxia Hui Autonomous Region from Dec 2016 to Dec 2020 were retrospectively analyzed. The severity of infection and the outcomes of a 3-year follow-up were compared among the patients with different bacterial infections. RESULTS A total of 454 strains of pathogens were isolated from ulcer specimens of the 348 diabetic foot patients, 261(75.00%) of whom had single infection;Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Pseudomonas aeruginosa were the common species of pathogens. The patients with S.aureus, E.faecalis, E.coli and P.aeruginosa infections whose Wagner classification were grade 3 and above accounted for 49.02%, 86.84%,73.68% and 83.87%, respectively. The patients with single infection of E.faecalis or P.aeruginosa had more severe infection, while the patients with single infection of S.aureus had mild infection. The 3-year follow-up showed that the ulcer healing rate of the patients with single infection of S.aureus was the highest, the incidence rate of minor amputations, major amputations and cardiac events and mortality rate were relatively low, the ulcer healing rate of the patients with E.coli infection was lowest, and the mortality rate of the patients was relatively high. CONCLUSION The diabetic foot patients complicated with coronary heart disease who have E.faecalis or P.aeruginosa infection have more severe infection, the patients with S.aureus infection have mild infection. The ulcer healing rate is highest within 3 years, the mortality rate is lowest;the ulcer healing rate of the patients with E.coli infection is lowest within 3 years, and the mortality rate is highest within 2 years.

关 键 词：细菌感染 糖尿病足 冠心病 长期生存 

分 类 号：R541.4[医药卫生—心血管疾病]