糖尿病患者合并肾周围炎的临床特点分析

Study on clinical characteristics of patients with diabetes mellitus complicated with perinephritis

目的探讨糖尿病患者合并肾周围炎的临床特点。方法回顾性分析2010年1月至2016年12月赤峰市医院收治的肾周围炎患者70例,比较糖尿病组和非糖尿病组肾周围炎患者的一般情况、临床表现、实验室检查、影像学表现、并发症及病原菌感染情况。结果与非糖尿病肾周围炎患者相比,糖尿病合并肾周围炎患者发热时间和住院时间更长(t=2.215,4.592,P<0.05),咳嗽发生率高(38.5%vs.16.1%,χ~2=4.221,P<0.05),低白蛋白血症比率高(92.3%vs.67.7%,χ~2=6.892,P<0.05),易合并肺部感染(30.8%vs.9.7%,χ~2=4.564,P<0.05)、胸腔积液(38.5%vs.16.1%,χ~2=4.221,P<0.05),易并发糖尿病酮症酸中毒(23.1%vs.0%,P<0.05),但腰痛发生率低(38.5%vs.64.5%,χ~2=4.690,P<0.05)。超声诊断肾周围炎的敏感性为7.1%(5/70),增强CT诊断肾周围炎的敏感性为95.7%(67/70)。结论糖尿病合并肾周围炎患者的临床表现不典型,CT有利于肾周围炎的早期诊断。

ObjectiveTo explore the clinical characteristics of perinephritis in diabetic patients.MethodsThe clinical data of70patients with perinephritis in this hospital during January2010to December2917were retrospectively reviewed.Their general condition,clinical manifestations,laboratory findings,imaging findings,complications and pathogens were compared among diabetic and non-diabetic patients.ResultsIn comparison with non-diabetic patients,diabetic patients complicated with perinephritis had a longer duration of fever and a longer duration for hospital stay(t=2.215,4.592,P<0.05).They also had higher incidence rates of coughing(38.5%vs.16.1%,χ2=4.221,P<0.05),hypoalbuminemia(92.3%vs.67.7%,χ2=6.892,P<0.05),pulmonary infection(30.8%vs.9.7%,χ2=4.564,P<0.05),pleural effusion(38.5%vs.16.1%,χ2=4.221,P<0.05)and diabetic ketoacidosis(23.1%vs.0%,P<0.05),but their prevalence rates of flank pain were lower(38.5%vs.64.5%,χ2=4.690,P<0.05).The sensitivity of ultrasonography(US)for diagnosis of perinephritis was7.1%.The sensitivity of computed tomography(CT)scanning was95.7%,hance it was more sensitive for the diagnosis of perinephritis.ConclutionThe clinical manifestations of perinephritis in diabetic patients are atypical.CT scanning is helpful in early diagnosis of perinephritis.