糖尿病合并社区获得性肺炎患者病原学特点及临床分析

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目的回顾性分析住院治疗的糖尿病合并社区获得性肺炎(CAP)患者病原体分布特征,并探讨其临床特点。方法对糖尿病组与非糖尿病组患者的临床特征、病原学分布分析,检测糖尿病组常见病原菌的耐药性。结果糖尿病组呼吸道症状及发热的发生率分别为76.8%、54.0%,低于非糖尿病组的86.5%、65.6%,神志改变的发生率12.1%,高于非糖尿病组的4.7%,差异有统计学意义(P<0.05)。糖尿病组重症肺炎发生率及死亡率分别为13.1%、9.1%,高于非糖尿病组的8.3%、5.2%,差异有统计学意义(P<0.05)。糖尿病组炎性相关指标WBC、CRP和PCT分别为(12.71±5.82)×109/L、(27.56±13.56)mg/L和(1.78±1.15)ng/m L,明显高于非糖尿病组的(10.40±4.07)×109/L、(20.43±10.76)mg/L和(1.01±0.78)ng/m L,差异有统计学意义(P<0.05)。糖尿病组病原学检测肺炎克雷伯杆菌、大肠埃希菌检测率高于非糖尿病组,差异有统计学意义。结论糖尿病组患者具有临床症状不典型、病情严重、重症肺炎发生机率高、死亡率高等特点,病原学检测肺炎克雷伯杆菌、大肠埃希菌感染比率高于非糖尿病组。 Objective To retrospectively analyze the distribution of pathogens in hospitalized diabetic patients with community-acquired pneumonia (CAP) and to investigate their clinical features. Methods The clinical features and etiological distribution of diabetic patients and non-diabetic patients were detected, and the drug resistance of common pathogens in diabetes mellitus was detected. Results The incidence of respiratory symptoms and fever in diabetic group were 76.8% and 54.0%, respectively, which were lower than those in non-diabetic group (86.5% and 65.6%, 12.1% and 2.4%, respectively), which were higher than those in non-diabetic group Significance (P <0.05). The incidence of severe pneumonia and mortality in diabetic group were 13.1% and 9.1%, respectively, higher than those in non-diabetic group (8.3% and 5.2%, respectively). The difference was statistically significant (P <0.05). The inflammatory markers WBC, CRP and PCT in diabetic group were (12.71 ± 5.82) × 109 / L, (27.56 ± 13.56) mg / L and (1.78 ± 1.15) ng / m L, respectively, which were significantly higher than those in non-diabetic group 10.40 ± 4.07 × 109 / L, (20.43 ± 10.76) mg / L and (1.01 ± 0.78) ng / m L, respectively, with significant difference (P <0.05). Pathogenic detection of Klebsiella pneumoniae in patients with diabetes, Escherichia coli detection rate was higher than non-diabetic group, the difference was statistically significant. Conclusion The patients with diabetes mellitus have the characteristics of atypical clinical symptoms, serious illness, high incidence of severe pneumonia and high mortality. The etiological detection of Klebsiella pneumoniae and Escherichia coli in the patients with diabetes mellitus was higher than that in non-diabetic patients.
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