胰岛素泵联合替加环素治疗2型糖尿病合并广泛耐药鲍氏不动杆菌肺炎的疗效

Effect of insulin pump and tegacycline on treatment of patients with type 2 diabetes mellitus complicated with pandrug-resistant Acinetobacter baumannii pneumonia

目的探讨胰岛素泵与替加环素治疗2型糖尿病(T2DM)合并广泛耐药鲍氏不动杆菌肺炎的疗效。方法选择2016年10月-2017年10月柳州市工人医院收治的2型糖尿病合并广泛耐药鲍氏不动杆菌肺炎患者86例,随机分为两组,对照组应用胰岛素泵联合头孢哌酮舒巴坦钠治疗,试验组应用胰岛素泵联合替加环素治疗,对比两组治疗效果、症状改善、细菌清除率、血清学指标、血清ET、CGRP水平变化、并发症发生情况。结果干预后,试验组治疗有效率97.7%高于对照组的74.4%(P<0.05);两组患者血糖水平均出现好转,试验组干预3 d、5 d血糖水平优于对照组(P<0.05);试验组患者血清学各项指标水平优于对照组(P<0.05);试验组患者并发症发生率为9.3%低于对照组25.6%(P<0.05);试验组低血糖发生率2.3%低于对照组13.9%(P<0.05)。结论 2型糖尿病合并肺部感染患者的干预过程中,采取胰岛素泵对其血糖水平加以控制后联合替加环素干预效果较为理想,患者症状改善及细菌清除率提高,血清ET、CGRP水平得到有效改善,应在临床治疗中进一步推广应用。

OBJECTIVE To explore the effect of insulin pump and tigecycline on treatment of type 2 diabetes mellitus(T2 DM) complicated with pandrug-resistant Acinetobacter baumannii pneumonia. METHODS Totally 86 patients with type 2 diabetes mellitus complicated with Acinetobacter baumannii pneumonia admitted to our hospital from Oct. 2016 to Oct. 2017 were randomly divided into two groups. The control group was treated with insulin pump combined with cefoperazone sulbactam sodium, and the experimental group was treated with insulin pump combined with tegacycline. The effect, symptoms improvement, bacterial clearance rate, serological indicators, changes of serum ET, calcitonin gene related peptide(CGRP) levels and occurrence of complications of the two groups were compared. RESULTS After the intervention, the effective rate of the treatment group was 97.7%, significantly higher than that of the control group(74.4%)(P<0.05). The blood glucose level of both groups was improved, and the blood glucose level of the experimental group was significantly better than that of the control group on day 3 and day 5(P<0.05). The levels of serum indicators of the experimental group were significantly better than the control group(P<0.05). The complication incidence of patients in the experimental group was 9.3%, significantly lower than that in the control group(25.6%)(P<0.05). The incidence of hypoglycemia in the experimental group was 2.3%, significantly lower than that in the control group(13.9%)(P<0.05). CONCLUSION During the intervention of type 2 diabetes mellitus patients with pulmonary infection, the effect of insulin pump combined with tegacycline is relatively ideal, the symptoms and bacterial clearance rate of patients are improved, and the levels of serum ET and CGRP are effectively improved, which should be further promoted and applied in clinical treatment.