儿童糖尿病合并尿路感染的临床特征及危险因素分析  

Analysis of clinical characteristics and risk factors for diabetes mellitus complicated with urinary tract infection in children

作　　者：尼加提·阿力木 马士凤[2] 夏木斯娅·阿里木江 张静 郑荣秀[2] NIJAT Alim;MA Shifeng;XAMSIYA Alim;ZHANG Jing;ZHENG Rongxiu(Graduate School of Tianjin Medical University,Tianjin 300070,China;Department of Pediatrics,Tianjin Medical University General Hospital;Department of Pediatrics,the Urumqi No.1 People's Hospital(Urumqi Children's Hospital))

机构地区：[1]天津医科大学研究生院,300070 [2]天津医科大学总医院儿科 [3]乌鲁木齐市第一人民医院(乌鲁木齐儿童医院)儿科

出　　处：《天津医药》2024年第10期1051-1055,共5页Tianjin Medical Journal

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-068C);天津市卫生健康委卫生健康科技项目(TJWJ2022XK008)。

摘　　要：目的探讨儿童糖尿病(DM)合并尿路感染(UTI)的临床特征和危险因素。方法160例儿童DM患者根据并发泌尿系感染分为UTI组和非UTI组,每组80例。收集儿童DM并发泌尿系感染的临床资料,包括DM类型、性别、年龄、体质量指数(BMI)、病程、住院时间、是否留置尿管、是否酮症酸中毒、抗生素及胰岛素使用情况、尿液标本分离细菌类型及入院时各项化验指标等结果,并进行分析。结果UTI组病原菌主要包括大肠埃希菌(37株,46.3%)、肠球菌(21株,26.2%)、肺炎克雷伯菌(9株,11.2%)等。单因素分析显示2组间肥胖、病程、住院时间、是否留置导尿管、是否酮症酸中毒、抗生素使用情况、糖化血红蛋白(HbA1c)、白蛋白(ALB)及血肌酐(Cr)的差异有统计学意义(P<0.05)。多因素分析显示DM合并UTI的危险因素包括住院时间延长(OR=2.087,95%CI:1.562~2.789)、留置导尿管(OR=15.886,95%CI:2.336~108.007)、酮症酸中毒(OR=9.300,95%CI:1.169~73.992)、病程≥36个月(OR=20.548,95%CI:2.425~174.119)、HbA1c升高(OR=16.686,95%CI:3.666~75.955)及血Cr升高(OR=1.010,95%CI:1.002~1.019);而血清ALB升高(OR=0.799,95%CI:0.702~0.910)为其保护因素。结论儿童DM合并UTI以大肠埃希菌感染为主,与住院时间、留置尿管、酮症酸中毒、病程时间、HbA1c、血Cr和ALB水平密切相关。Objective To investigate clinical features and risk factors of childhood diabetes mellitus(DM)complicated with urinary tract infection(UTI).Methods The data of 160 children with DM in our hospital in the past 2 years were collected as the research object,and they were divided into the UTI group and the non-UTI group UTI,with 80 cases in each group.The clinical data of children with DM and UTI were collected and analyzed,including DM type,sex,age,body mass index(BMI),living environment,duration of disease,length of hospital stay,indwelling catheter,ketoacidosis,antibiotic and insulin use,the types of bacteria isolated from urine samples and various laboratory indicators on admission.Results Pathogen bacteria mainly included Escherichia coli(n=37,46.2%),Enterococci(n=21,26.2%)and Klebsiella pneumoniae(n=9,11.2%)in the UTI group.Univariate analysis showed that there were significant differences in obesity,duration of disease,length of hospital stay,indwelling catheter,ketoacidosis,antibiotic use,glycosylated hemoglobin(HbA1c),albumin(ALB)and serum creatinine(Cr)between the two groups(P<0.05).Multivariate regression analysis showed that risk factors for DM complicating UTI included prolonged hospitalization(OR=2.087,95%CI:1.562-2.789),indwelling urinary catheter(OR=15.886,95%CI:2.336-108.007),ketoacidosis(OR=9.300,95%CI:1.169-73.992),duration of disease≥36 months(OR=20.548,95%CI:2.425-174.119),increased HbA1c(OR=16.686,95%CI:3.666-75.955)and serum Cr(OR=1.010,95%CI:1.002-1.019),while the increased serum ALB(OR=0.799,95%CI:0.702-0.910)was its protective factor.Conclusion Pathogenic bacteria in the UTI group are mainly Escherichia coli.Children with DM and UTI are closely related to the length of hospitalization,indwelling catheter,ketoacidosis,duration of disease,HbA1c,serum Cr and ALB levels.

关 键 词：糖尿病 危险因素 尿路感染 临床特征 儿童 

分 类 号：R725.871[医药卫生—儿科]