女性2型糖尿病患者合并无症状菌尿的临床分析

Clinical analysis on asymptomatic bacteriuria in women patients with type 2 diabetes

目的 探讨影响女性 2型糖尿病合并无症状菌尿 (ASB)的主要危险因素以及有关临床特点。方法 采用病例对照研究 ,2型糖尿病伴无症状菌尿 (ASB+ )组 12 8例 ,2型糖尿病不伴ASB(ASB-)组 30 0例 ,正常对照组 74例。结果 ①女性 2型糖尿病合并ASB的发病率为 30 % ;②与ASB有关的危险因素包括年龄、病程、糖尿病视网膜病变、糖尿病肾病、糖尿病神经病变、既往尿路感染史、大血管疾病、高脂血症、绝经史 ,其中最主要的 3个危险因素是年龄、大量白蛋白尿、既往尿路感染史 ;③随着糖尿病肾病、视网膜病变病情的加重 ,糖尿病合并ASB的发病率也相应增加 ;④糖尿病合并ASB+ 中段尿培养病原微生物以大肠埃希菌为主。结论 ①影响女性 2型糖尿病合并ASB的因素众多 ,主要因素是年龄、大量白蛋白尿、既往尿路感染史 ;②血糖对女性 2型糖尿病合并ASB发病作用降低 ;③ASB可能是女性 2型糖尿病的一个并发症。

Objective To explore the risk factors associated with asymptomatic bacteriuria(ASB)and some clinical characteristics in women with type 2 diabetes.Methods The investigation was conducted by means of case control study,including 128 patients of type 2 diabetes with asymptomatic bacteriuria(ASB +),300 type 2 diabetes without ASB(ASB -),74 nondiabetic controls.Results ①The prevalence of ASB in women patients with type 2 diabetes was 30%.②Risk factors related to ASB including age,diabetes duration,diabetic retinopathy(DR),diabetic nephropathy(DN),diabetic neuropathy,urinary tract infection(UTI) history,macrovascular disease,hyperlipidia,postmenopause.Age,macroalbuminuria and UTI history were the most important of all above variables.③The prevelance of ASB in women patients with type 2 diabetes increased when the conditions of DN,DR got worse.④The most frequent causative angent of ASB in women patients with type 2 diabetes was E.Coli.Conclusion ①The risk factors of ASB in women with type 2 diabetes include age,diabetes duration, DR, DN,diabetic neuropathy, UTI history,macrovascular disease,hyperlipidia,postmenopause.Age,macroalbuminuria and UTI history were the most important risk factors of all.②Effects of plasma glucose on ASB in women patients with type 2 diabetes are decreased.③ASB may be considered one of complications in women with type 2 diabetes.