2型糖尿病与肛周脓肿的关系及病原菌耐药性比较  

Correlation between type 2 diabetes mellitus and perianal abscess and comparison of drug resistance of pathogens

作　　者：王梦如 皇甫少华[2] 邵鑫[3] WANG Mengru;HUANGFU Shaohua;SHAO Xin(Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210001,China;Department of Anorectal,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210001,China;Department of Endocrinology,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210001,China)

机构地区：[1]南京中医药大学附属南京中医院,江苏南京210001 [2]南京中医药大学附属南京中医院肛肠科,江苏南京210001 [3]南京中医药大学附属南京中医院内分泌科,江苏南京210001

出　　处：《中国医药科学》2025年第5期67-71,共5页China Medicine And Pharmacy

基　　金：国家自然科学基金青年基金(82004365);江苏省南京市中医药青年人才培养计划(ZYQ20023);中华中医药学会雏鹰计划中医临床青年人才研修项目(第一期)。

摘　　要：目的分析2型糖尿病糖脂代谢与肛周脓肿炎症反应的关系,并比较2型糖尿病合并肛周脓肿和单纯肛周脓肿患者的病原菌及其耐药性的差异。方法选取2014年1月至2024年3月在南京中医药大学附属南京中医院肛肠科确诊并手术治疗的379例肛周脓肿患者,根据是否合并2型糖尿病分为研究组(2型糖尿病合并肛周脓肿患者)和对照组(单纯肛周脓肿患者),分析研究组糖化血红蛋白、甘油三酯、胆固醇、高密度脂蛋白、低密度脂蛋白水平与白细胞、中性粒细胞计数的关系,并比较两组病原菌及其耐药性差异。结果研究组白细胞和中性粒细胞水平的升高与糖化血红蛋白、甘油三酯、高密度脂蛋白异常有关(P<0.05)。研究组病原菌以肺炎克雷伯菌为主,对照组以大肠埃希菌为主,两组肺炎克雷伯菌和大肠埃希菌差异有统计学意义(P<0.05)。两组病原菌耐药率差异无统计学意义(P>0.05),肺炎克雷伯菌未发现对抗生素耐药率超过40%,大肠埃希菌对头孢、喹诺酮和磺胺类抗生素耐药率超过40%,但对碳青霉烯、多肽和β-内酰胺酶抑制剂类抗生素未发现耐药菌株。结论2型糖尿病糖脂代谢异常的肛周脓肿患者炎症反应更强烈;2型糖尿病合并肛周脓肿和单纯肛周脓肿患者主要病原菌不同,但其耐药率无明显差异。Objective To analyze the correlation between glycolipid metabolism and inflammatory reaction of perianal abscess in type 2 diabetes mellitus,and to compare the differences of pathogenic bacteria and their drug resistance between perianal abscess and simple perianal abscess in type 2 diabetes mellitus.Methods A total of 379 patients with perianal abscess diagnosed and surgically treated in the Department of Anorectal of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2014 to March 2024 were selected and divided into the study group(type 2 diabetes mellitus patients with perianal abscess)and the control group(patients with simple perianal abscess)according to whether they were complicated by type 2 diabetes mellitus.The Correlations between glycosylated hemoglobin,triglyceride,cholesterol,high-density lipoprotein and low-density lipoprotein levels and the count of white blood cells and neutrophils in the study group were analyzed,and the differences of pathogens and their drug resistance between the two groups were compared.Results The increase of leukocyte and neutrophil levels in the study group was related to the abnormality of glycosylated hemoglobin,triglyceride and high-density lipoprotein(P<0.05).Klebsiella pneumoniae was the main pathogen in the study group,while Escherichia coli was the main pathogen in the control group(P<0.05).The differences between the two groups for Klebsiella pneumoniae and Escherichia coli were statistically significant(P<0.05).There was no difference in drug resistance rate between the two groups(P>0.05).Klebsiella pneumoniae was not found to be more than 40%resistant to antibiotics,and Escherichia coli was more than 40%resistant to cephalosporins,quinolones and sulfonamides,but no resistant strains were found to carbapenem,peptides andβ-lactamase inhibitors.Conclusion The inflammatory reaction of patients with perianal abscess with abnormal glycolipid metabolism in type 2 diabetes mellitus is stronger.The main pathogens in pa

关 键 词：2型糖尿病 肛周脓肿 糖脂代谢 炎症水平 病原菌 耐药性 

分 类 号：R587.1[医药卫生—内分泌] R657.15[医药卫生—内科学]