糖尿病肾病患者并发泌尿系感染的logistic分析及血清CRP和Cys-C水平变化

Logistic analysis of urinary infection in patients with diabetic nephropathy and changes in serum CRP and Cys-C levels

目的糖尿病肾病(DN)患者并发泌尿系感染的logistic分析并探究其血清C反应蛋白(CRP)、胱抑素C(Cys-C)水平变化。方法选取2019年1月-2023年1月福建医科大学附属协和医院收治的155例DN患者作为研究对象,对所有患者泌尿系感染情况进行统计,根据感染情况将其分为感染组(n=37)和未感染组(n=118),比较2组患者性别、年龄、病程、住院时间、体质指数(BMI)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、钙(Ca)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、抗生素使用、低蛋白血症情况,采用logistic回归分析DN患者并发泌尿系感染的影响因素,比较2组患者血清CRP、Cys-C水平。结果2组年龄、病程、住院时间、HbA1c、FPG、Ca、低蛋白血症比较差异均有统计学意义(P均<0.05)。多因素logistic回归结果显示,年龄(OR=3.111,95%CI:1.121~8.638)、FPG(OR=3.209,95%CI:1.360~7.572)、Ca(OR=2.604,95%CI:1.361~4.982)、低蛋白血症(OR=2.565,95%CI:1.462~4.502)为DN患者并发泌尿系感染的影响因素(P均<0.05)。感染组血清CRP、Cys-C水平[(22.91±7.28)、(3.77±1.21)mg/L]显著高于非感染组[(11.37±5.54)、(2.67±1.15)mg/L],差异均有统计学意义(t=10.216、5.014,P均<0.05)。结论年龄、FPG、Ca、低蛋白血症为DN患者并发泌尿系感染的影响因素,临床应对上述指标引起重视,采取合理有效的措施减少患者感染发生情况;DN患者泌尿系感染后CRP、Cys-C水平升高。

Objective To conduct logistic analysis of urinary infection in patients with diabetic nephropathy(DN),and investigate the changes in serum C-reactive protein(CRP)and cystatin C(Cys-C)levels.Methods A total of 155 patients with DN were admitted to the Union Hospital Affiliated to Fujian Medical University from January 2019 to January 2023.According to the presence or absence of urinary infection,the patients were divided into infected group(n=37)and uninfected group(n=118).Gender,age,course of disease,length of hospital stay,body mass index(BMI),glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),calcium(Ca),cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),antibiotic use and hypoalbuminemia were compared between the two groups.Logistic regression analysis was performed to screen the influencing factors of urinary infection in patients with DN.Serum CRP and Cys-C levels in the two groups were comparatively analyzed.Results There were statistically significant differences between the two groups in terms of age,course of disease,length of hospital stay,HbA1c,FPG,Ca and hypoproteinemia(all P<0.05).Multivariate logistic regression found that age(OR=3.111,95%CI:1.121-8.638),FPG(OR=3.209,95%CI:1.360-7.572),Ca(OR=2.604,95%CI:1.361-4.982)and hypoproteinemia(OR=2.565,95%CI:1.462-4.502)were influencing factors of urinary infections in patients with DN.Serum CRP and Cys-C levels in the infected group[(22.91±7.28),(3.77±1.21)mg/L]were significantly higher than those in the uninfected group[(11.37±5.54),(2.67±1.15)mg/L],the differences were statistically significant(t=10.216,5.014,all P<0.05).Conclusions Age,FPG,Ca and hypoproteinemia were influencing factors of urinary infection in patients with DN.In clinical practice,attention should be paid to above-mentioned indicators,and reasonable and effective measures should be taken to reduce the incidence of infection.In addition,the levels of CRP and Cys-C in patients with urinary tract infection were relatively high.