糖尿病合并尿路感染患者酮症酸中毒的影响因素分析  

Factors influencing ketoacidosis in patients with diabetes and urinary tract infection

作　　者：刘文 向世强[1] 龚雅琪[2] 袁华兵 徐金娥[2] LIU Wen;XIANG Shiqiang;GONG Yaqi;YUAN Huabing;XU Jin'e(School of Medicine,Wuhan University of Science and Technology,Wuhan 430065,China;Department of Endocrinology,The First People’s Hospital of Tianmen in Hubei Province,Tianmen 431700,Hubei Province,China)

机构地区：[1]武汉科技大学医学院,武汉430065 [2]天门市第一人民医院内分泌科,湖北天门431700

出　　处：《医学新知》2024年第3期276-281,共6页New Medicine

基　　金：湖北省自然科学基金项目(2022CFB514)。

摘　　要：目的探讨2型糖尿病合并尿路感染患者糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的临床特点及影响因素,为DKA预防及早期干预提供参考。方法回顾性收集2022年1月至2023年9月天门市第一人民医院收治的糖尿病合并尿路感染患者的病历资料,根据住院期间是否发生DKA分为DKA组和非DKA组,比较分析DKA发生的影响因素。结果共纳入137例患者,其中DKA组35例、非DKA组102例,DKA发生率为25.55%,两组患者在年龄以及空腹血糖、糖化血红蛋白(HbA1c)、血清降钙素原(PCT)、尿白细胞水平方面差异均具有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄≥60岁[OR=2.369,95%CI(1.013,5.541)]、血清PCT≥0.5 ng·L-1[OR=3.234,95%CI(1.215,8.609)]、HbA1c≥7%[OR=2.958,95%CI(1.130,7.743)]是糖尿病合并尿路感染者发生DKA的危险因素。结论年龄≥60岁、血清PCT≥0.5 ng·L-1及HbA1c≥7%是糖尿病合并尿路感染者发生DKA的独立危险因素,临床医生应及时识别,尽早预防。Objective To investigate the clinical characteristics and influencing factors of diabetic ketoacidosis(DKA)patients with diabetes mellitus type 2 complicated with urinary tract infection,and to provide reference for the prevention and early intervention of DKA.Methods The medical records of patients with diabetes mellitus complicated with urinary tract infection admitted to the First People's Hospital of Tianmen in Hubei Province from January 2022 to September 2023 were retrospectively collected,and the patients were divided into DKA group and non-DKA group according to whether DKA occurred during hospitalization,and the influencing factors of DKA were compared and analyzed.Results A total of 137 patients were collected,including 35 cases in the DKA group and 102 cases in the non-DKA group,the incidence rate of DKA is 25.55%.There were significant differences in age,fasting blood glucose levels,glycosylated hemoglobin(HbA1c),serum procalcitonin(PCT)and urinary leukocyte levels between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years[OR=2.369,95%CI(1.013,5.541)],blood PCT≥0.5 ng·L-1[OR=3.234,95%CI(1.215,8.609)]and HbA1c≥7%[OR=2.958,95%CI(1.130,7.743)]were risk factors for DKA in patients with diabetes mellitus and urinary tract infection.Conclusion Age≥60 years,blood PCT≥0.5 ng·L-1,and HbA1c≥7%were independent risk factors for DKA in patients with diabetes mellitus and urinary tract infection.Clinicians should identify it in time for early prevention.

关 键 词：糖尿病 酮症酸中毒 尿路感染 危险因素 

分 类 号：R587.2[医药卫生—内分泌]