糖尿病肾病患者血液透析肺部感染临床特点与相关因素分析

Clinical analysis of characteristics and related factors of lung infections in patients with diabetic nephropathy undergoing hemodialysis

目的探讨糖尿病肾病血液透析合并肺部感染患者临床特征及危险因素,为临床诊治提供参考。方法回顾性分析2012年1月-2015年1月糖尿病肾病患者168例,所有患者临床资料完整,均实施血液透析治疗,统计患者感染率并分析病原学特点,对患者性别、年龄、透析时间、血红蛋白等相关因素实施单因素及多因素分析,总结危险因素。结果 168例患者发生肺部感染40例,感染率为23.81%;共分离出51株病原菌,检出肺炎克雷伯菌及金黄色葡萄球菌最多,分别占33.33%及19.61%;相关因素分析显示,透析时间、血红蛋白、血清白蛋白、营养不良、空腹血糖、肾功能是糖尿病肾病血液透析患者发生肺部感染独立危险因素(P<0.05)。结论糖尿病肾病血液透析患者肺部感染率高,独立危险因素多,临床应加强营养补充、血糖控制、纠正贫血等措施,以降低感染率。

OBJECTIVE To investigate clinical characteristics and related factors of lung infections in hemodialysis for diabetic nephropathy,so as to provide a reference for clinical treatment.METHODS A retrospective analysis was conducted on 168 cases of diabetic nephropathy treated from Jan.2012 to Jan.2015.All patients had complete clinical data,and hemodialysis treatment was performed.Statistical analysis of patient infection rate and etiological characteristics were made.Univariate and multivariate analyses of genders,age,duration of dialysis and hemoglobin were implemented to summarize risk factors.RESULTS Totally 40 cases out of 168 patients were diagnosed with postoperative lung infections,the infection rate was 23.81%.The 40 patients were isolated with 51 pathogens,Klebsiella pneumoniae and Staphylococcus aureus were the main pathogen types accounting for33.33% and 19.61% respectively.Univariate and multivariate analysis showed that the duration of dialysis,hemoglobin,serum albumin,malnutrition,fasting blood sugar,kidney function were independent risk factors for lung infections in hemodialysis for diabetic nephropathy（P〈0.05）.CONCLUSION Patients with diabetic nephropathy undergoing hemodialysis have high lung infection rates and multiple independent risk factors.Clinical nutrition supplements,blood sugar control,correction of anemia and other measures should be strengthened to reduce infection rates.