2型糖尿病合并肺部感染病原菌类型及肺部CT特征分析  

Analysis of distribution characteristics of pathogenic bacteria and CT diagnosis characteristics of lung in type 2 diabetes patients with pulmonary infection

作　　者：张丽[1] 赵静[1] 王晨菲[1] ZHANG Li;ZHAO Jing;WANG Chenfei(The Fifth Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830000,China)

机构地区：[1]新疆医科大学第五附属医院,新疆乌鲁木齐830000

出　　处：《中国病原生物学杂志》2023年第5期589-592,597,共5页Journal of Pathogen Biology

摘　　要：目的分析2型糖尿病合并肺部感染患者的病原菌分布及肺部CT特征。方法选取173例于新疆医科大学第五附属医院进行治疗的2型糖尿病合并肺部感染患者为研究对象。于患者接受治疗前,采集其痰液、支气管肺泡灌洗液后采用全自动细菌鉴定分析仪进行病原菌鉴定。所有患者在治疗前、后均进行肺部CT检查,观察不同肺部感染类型患者的CT影像特点。患者经治疗后,观察记录患者血糖控制情况与疗效,分析患者血糖控制情况与肺部感染治疗效果的相关性。结果共检出病原菌173株。革兰阳性菌42株(24.28%),主要为肺炎链球菌(15.61%)、金黄色葡萄球菌(5.78%)。革兰阴性菌112株(64.74%),主要为肺炎克雷伯菌(15.03%)、鲍曼不动杆菌(12.72%)。经CT检查,肺炎154例,以小叶肺炎(45.09%)为主,肺结核患者10例,真菌感染9例。不同肺部疾病患者的CT影像特点具有差异化。大叶肺炎患者CT影像显示大片状实变阴影沿肺段分布;小叶肺炎患者CT影像显示,点、斑片状沿支气管血管分布,肺结核患者CT影像显示均为活动性肺结核,15个肺段产生病灶,全部伴有肺门纵膈淋巴结肿大;肺曲菌病患者CT影像空洞内可见可移动圆形结节影;肺念珠病患者CT影像显示大块成片状实变影。肺部感染患者抗菌药物使用情况,主要为单联使用药物方式(86.71%),以头孢菌素、第三代喹诺酮类为主。11.56%采用两联使用抗菌药物,头孢菌素+喹诺酮类使用频次最高。173例2型糖尿病合并肺部感染患者经过治疗后,136例患者血糖控制良好,患者痊愈、好转率为86.76%,显著高于血糖控制不良患者组,差异有统计学意义(χ^(2)=14.049,P<0.05)。结论2型糖尿病合并肺部感染患者病原菌主要以肺炎克雷伯菌、鲍曼不动杆菌、肺炎链球菌为主,肺部感染类型多小叶肺炎。临床治疗一般以以头孢菌素、第三代喹诺酮类为主,控制血糖有助于肺部感染的Objective The distribution of pathogenic bacteria and CT features of lung in patients with type 2 diabetes complicated with pulmonary infection was investigated.Methods 173 type 2 diabetes patients with pulmonary infection who were treated in the Fifth Affiliated Hospital of Xinjiang Medical University were selected as the subjects of this study.Before receiving treatment,the patient's sputum and bronchoalveolar lavage fluid were collected,and then the pathogen was identified by automatic bacterial identification analyzer.All patients underwent lung CT examination before and after treatment to observe the CT image characteristics of patients with different types of lung infection.After treatment,observe and record the blood glucose control and curative effect of patients,and analyze the correlation between the blood glucose control and the therapeutic effect of pulmonary infection.Results 173 strains of pathogenic bacteria were detected.There were 42 strains(24.28%)of gram-positive bacteria,mainly Streptococcus pneumoniae(15.61%)and Staphylococcus aureus(5.78%).There were 112 gram-negative bacteria(64.74%),mainly Klebsiella pneumoniae(15.03%)and Acinetobacter baumannii(12.72%).CT examination showed that 154 cases of pneumonia were mainly lobular pneumonia(45.09%),10 cases of pulmonary tuberculosis and 9 cases of fungal infection.The CT image characteristics of patients with different lung diseases were different.CT images of patients with lobar pneumonia showed massive consolidation shadows distributed along the lung segments;CT images of patients with lobular pneumonia showed that dots and patches were distributed along the bronchial vessels.CT images of patients with pulmonary tuberculosis showed that they were all active pulmonary tuberculosis,with lesions in 15 lung segments,all accompanied by hilar and mediastinal lymph nodes enlargement;Movable round nodules can be seen in the cavity of pulmonary aspergillosis patients on CT images;CT images of patients with pulmonary candidiasis showed massive and patchy c

关 键 词：2型糖尿病 肺部感染 病原菌 CT特点 

分 类 号：R378[医药卫生—病原生物学]