糖尿病足患者病原菌分布及血清炎性因子与病情及预后的相关性分析

Analysis of Pathogen Distribution and the Correlation Between Serum Inflammatory Factors and Disease Condition and Prognosis in Diabetic Foot Patients

目的:分析糖尿病足患者病原菌分布及血清炎性因子与病情及预后的相关性。方法:选择济南市中心医院2018年1月至2019年5月收治的86例糖尿病足患者的临床资料,依据糖尿病足感染程度分为轻度感染组30例、中度感染组33例和重度感染组23例;依据糖尿病足转归情况分为治愈28例、好转44例及无效14例;同期选择78例本院健康体检者作为对照组。分析糖尿病足患者病原菌分布情况,比较各组血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)和白介素-6(IL-6)水平。结果:86例糖尿病足患者共分离102例株病原菌,以革兰阴性菌为主,主要为铜绿假单胞菌和鲍氏不动杆菌,其次为革兰阳性菌,主要为金黄色葡萄球菌和表皮葡萄球菌。糖尿病足不同感染程度组血清炎性因子水平均高于对照组,差异有统计学意义(P<0.05);糖尿病足重度感染组血清炎性因子水平显著高于中度感染组及轻度感染组(P<0.05)。糖尿病足无效者血清炎性因子水平显著高于治愈和好转组,差异有统计学意义(P<0.05)。结论:糖尿病足患者病原菌分布以革兰阴性菌为主,随着感染程度的加重血清炎性因子水平显著上升,此外血清炎性因子水平能够反映糖尿病足患者的临床效果。

Objective:To analyze the distribution of pathogenic bacteria in diabetic foot patients and the correlation between serum inflammatory factors and disease condition and prognosis.Methods:The clinical data of 86 diabetic foot patients admitted to Jinan Central Hospital from January 2018 to May 2019 were selected and divided into mild infection group(30 cases),moderate infection group(33 cases)and severe infection group(23 cases)according to the infection degree of diabetic foot.As to the outcome of treatment,28 cases were cured,44 cases were improved and 14 cases were ineffective.At the same time,78 health controls were made the control group.The distribution of pathogenic bacteria in diabetic foot patients was analyzed.The levels of serum procalcitonin(PCT),high sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)in each group were compared.Results:A total of 102 strains of pathogenic bacteria were isolated from 86 patients with diabetic foot.Gram-negative bacteria were dominant,mainly Pseudomonas aeruginosa and Acinetobacter baumannii,followed by Gram-positive bacteria,mainly Staphylococcus aureus and Staphylococcus epidermidis.The levels of serum inflammatory factors in diabetic foot infection groups with different degrees were higher than those in the control group,and the difference was statistically significant(P<0.05).The level of serum inflammatory factors in diabetic foot severe infection group was significantly higher than that in moderate infection group and mild infection group(P<0.05).The levels of serum inflammatory factors in patients with diabetic foot failure were significantly higher than those in the cured and improved groups,and the difference was statistically significant(P<0.05).Conclusion:The distribution of pathogenic bacteria in diabetic foot patients is dominated by gram-negative bacteria,and the level of serum inflammatory factors increases significantly with the aggravation of infection degree.In addition,the level of serum inflammatory factors can reflect the clinical effectiveness of diabetic foot patients.