老年2型糖尿病尿路感染病原菌与危险因素及Toll样受体-4基因表达水平  

Research on pathogen distribution,toll-like receptor-4 gene expression and risk factors of urinary tract infection in elderly patients with type 2 diabetes mellitus

作　　者：李金娟[1] 许海琦[1] 刘晓莉[1] 李永桂 田雨 杨历新[1] LI Jin-juan;XU Hai-qi;LIU Xiao-li;LI Yong-gui;TIAN Yu;YANG Li-xin(Qinghai Provincial People's Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海省人民医院内分泌科,青海西宁810000

出　　处：《中华医院感染学杂志》2024年第15期2297-2301,共5页Chinese Journal of Nosocomiology

基　　金：青海省卫生健康委员会指导性计划项目(2021-wjzdx-20)。

摘　　要：目的分析老年2型糖尿病尿路感染患者病原菌分布、Toll样受体-4(TLR4)基因表达水平及其影响因素.方法选取2019年9月—2022年9月青海省人民医院收治的老年2型糖尿病尿路感染患者104例纳入研究组,另择老年2型糖尿病无尿路感染患者117例作为对照组,回顾性收集患者临床资料;分析老年2型糖尿病尿路感染患者病原菌特征,比较两组临床资料及外周血中性粒细胞TLR4 mRNA水平,Logistic回归分析老年2型糖尿病尿路感染的影响因素.结果104例老年2型糖尿病尿路感染患者共分离出病原菌121株,其中革兰阴性菌83株,革兰阳性菌34株,真菌4株,占比分别为68.60%、28.10%、3.31%;Logistic分析结果显示,年龄升高、泌尿系统结石、入侵式操作、血清糖化血红蛋白(HbA1c)水平升高、外周血中性粒细胞TLR4 mRNA水平升高为老年2型糖尿病尿路感染的危险因素(P<0.05),血清血红蛋白(ALB)水平升高为老年2型糖尿病尿路感染的保护因素(P<0.05).结论老年2型糖尿病尿路感染主要病原菌为革兰阴性菌,Logistic分析结果显示危险因素较多,临床可据此进行针对性干预.OBJECTIVE To analyze the distribution of pathogenic bacteria,toll-like receptor-4(TLR4)gene expres-sion and risk factors of urinary tract infection in elderly patients with type 2 diabetes.METHODS A total of 104 elderly patients with type 2 diabetes and urinary tract infection admitted to the People's Hospital of Qinghai Pro-vincial from Sep 2019 to Sep 2022 were included in the study group,and 117 elderly patients with type 2 diabetes without urinary tract infection were included in the control group.Clinical data of the patients were retrospectively collected.The characteristics of pathogenic bacteria in elderly patients with type 2 diabetes urinary tract infection were analyzed,and clinical data and TLR4 mRNA levels of peripheral neutrophils were compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors of urinary tract infec-tion in elderly patients with type 2 diabetes.RESULTS A total of 121 strains of pathogenic bacteria were isolated from 104 elderly patients with type 2 diabetes and urinary tract infection,including 83 strains of gram-negative bacteria,34 strains of gram-positive bacteria and 4 strains of fungi,accounting for 68.60%,28.10%and 3.31%,respectively.Multivariate logistic analysis showed that increasing age,urinary calculi,invasive procedures,higher serum level of glycated hemoglobin(HbA1c)and peripheral neutrophil mRNA level of TLR4 were risk factors for urinary tract infection in the elderly with type 2 diabetes(P<0.05),while elevated serum level of albumin(ALB)was a protective factor for urinary tract infection in the elderly with type 2 diabetes(P<0.05).CONCLUSION The main pathogenic bacteria of urinary tract infection in elderly patients with type 2 diabetes were gram-negative bacteria.Many influencing factors for the urinary tract infection by logistic analysis,and clinical in-tervention can be carried out accordingly.

关 键 词：老年2型糖尿病 尿路感染 病原菌 TOLL样受体4 危险因素 

分 类 号：R691.3[医药卫生—泌尿科学]