糖尿病肾病并发感染的临床特点及相关因素分析

Clinical features and analysis on correlative factors of DN complicated infection

目的探讨糖尿病肾病（DN）并发感染的临床特点和相关因素。方法回顾分析78例DN患者的感染部位、病原菌种类、糖化血红蛋白（HbA1c）、血清白蛋白（ALB）、血红蛋白（Hb）、血尿素氮（BUN）、血肌酐（SCr）、24h尿蛋白f定量等与感染的相关性。结果78例DN患者有47例并发感染，感染率为60．2％，肺部感染和泌尿道感染最常见。行各类标本病原菌培养63例次，培养阳性47例次，阳性率为74．6％，以大肠埃希菌（44．7％）和肺炎克雷伯菌（19．1％）最常见。感染组HbA1c、Hb、BUN、SCr、24h尿蛋白定量与非感染组比较有显著差异（P〈0．01）。结论DN患者感染发病率高，治疗效果差，积极控制血糖，加强营养，改善贫血，保护肾功能可提高疗效。

Objective To explore the clinical features and correlative factors of diabetic nephropathy （DN） complicated infection. Methods A retrospective analysis was made on the correlation among the infection and infection position, types of bacteria of pathogeny, glycated hemoglobin （ HbA1c ）, serum albumin （ ALB ）, hemoglobin （ Hb）, blood urea nitrogen （ BuN）, creatinine （Scr） and 24 hours＇ urine protein excretion of 78 cases DN patients. Results Of 78 cases DN patients, 47 cases occurred complicated infection with infection ratio of 60. 2%, in which the lung infection and urinary tract infection were common. The cultivation of various bacteria of pathogeny was carried out for 63 case/times, including the positive of 47 case/times, covering 74. 6%, in which most of them were Escherichia Coil （ 44. 1% ） and Klebsislla Pneumoniae （19. 1% ）. Comparing the HbAlc, Hb, BuN, Scr and 24 hours＇urine protein excretion in infection group with those in non-infection group, the differences were obvious （ P 〈 0. 01 ）. Conclusion The DN patients are characterized with high ratio of incidence and bad curative effect. If the blood sugar is actively controlled, nourishment is strengthened, anaemia is improved and kidney function is protected, then the curative effect will be improved.