老年2型糖尿病合并肺部感染患者的预后危险因素

Prognostic risk factors in elderly patients with type 2 diabetes mellitus complicated with pulmonary infection

中文关键词: 老年  2型糖尿病  肺部感染  病原菌分布  预后  危险因素

英文关键词: elderly  type 2 diabetes mellitus  pulmonary infection  pathogenic bacteria distribution  prognosis  risk factor

中文摘要:

      目的 研究老年2 型糖尿病(T2DM)合并肺部感染患者病原菌分布及临床预后相关因素.方法 选取2017 年9 月—2022 年9 月北京市大兴区人民医院住院治疗的196 例老年T2DM合并肺部感染患者临床资料进行回顾性研究,分析患者临床资料和病原菌鉴定结果;根据预后将患者分为存活组(n =136)和死亡组(n =60),比较 2 组病原菌分布并探讨影响患者预后的相关因素.结果 160 例老年 T2DM合并肺部感染患者共分离出病原菌 219 株,其中 23 例(占比14.38%)患者同时合并2 种病原菌感染,7 例(占比4.38%)患者同时合并3 种病原菌感染;病原菌种类包括革兰阴性菌139 株(63.47%)、革兰阳性菌67 株(30.59%)及真菌 13 株(5.94%);死亡组和存活组病原菌分布差异无统计学意义(P＞0.05).多因素二元Logistics回归分析显示,ALB水平高于 40 g/L、CRP水平高于 10×109/L、FBG水平高于12.79 mmol/L、低氧血症、病原菌耐药及多重感染为老年T2DM合并肺部感染患者死亡的独立危险因素(P＜0.05).结论 ALB、CRP、FBG水平、低氧血症、病原菌耐药及多重感染可能是影响患者预后的主要因素,临床需注意防控.

英文摘要:

      Objective To investigate the pathogenic bacteria distribution and prognostic-related factors in elderly pa-tients with type 2 diabetes mellitus(T2DM)complicated with pulmonary infection.Methods A retrospective study was con-ducted on the clinical data of 196 elderly patients with T2DM complicated with pulmonary infection who received hospitalization treatment in People's Hospital of Daxing District from September 2017 to September 2022.Their clinical data and pathogenic bacteria identification results were analyzed.They were divided into survival group(136 cases)and death group(60 cases)ac-cording to their prognosis.The distribution of pathogenic bacteria was compared between the two groups and the related factors affecting the prognosis of patients were explored.Results A total of 219 strains of pathogenic bacteria were isolated from these 160 elderly patients.Among them,23 ones(14.38% )were simultaneously infected with two types of pathogenic bacteria,and 7 ones(4.38% )were simultaneously infected with three types of pathogenic bacteria.The types of pathogens included 139 strains of Gram-negative bacteria(63.47% ),67 strains of Gram-positive bacteria(30.59% ),and 13 strains of fungi(5.94% ).There was no statistically significant difference in the distribution of pathogenic bacteria between the death group and the survival group(P＞0.05).Multivariate logistics regression analysis showed that ALB＞40 g/L,CRP＞10×109/L,FBG＞12.79 mmol/L,hypoxemia,pathogenresistanceandmultipleinfectionswereindependentriskfactorsfordeathinelder-ly patients with T2DM complicated with pulmonary infection(P＜0.05).Conclusion ALB,CRP,FBG,hypoxemia,patho-gen resistance and multiple infections may be the main factors affecting the prognosis of patients.Clinical attention should be paid to prevention and control.