经血流与经尿路感染大肠埃希菌的2型糖尿病患者血清降钙素原、纤维蛋白原降解产物水平比较

Comparisons of serum procalcitonin and fibrinogen degradation product levels between type 2 diabetes mellitus patients with Escherichia coli bloodstream and urinary tract infections

目的比较经血流与尿路感染大肠埃希菌的2型糖尿病患者血清降钙素原(PCT)、血浆纤维蛋白原降解产物(FDP)的水平。方法回顾性分析大同大学附属第一医院(大同市第五人民医院)2014年12月至2019年12月收治的大肠埃希菌感染2型糖尿病患者82例的临床资料,根据患者感染途径分为血流感染组(40例)及尿路感染组(42例),均进行PCT、FDP、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、C反应蛋白(CRP)、白细胞(WBC)、D-二聚体(DDi)、抗凝血酶Ⅲ活性、血电解质等检测,两组上述资料进行比较;以PCT与其他变量进行相关分析;并以PCT为因变量,其他相关指标为自变量,进行多元线性回归分析。结果两组比较,血流感染组体温(T)[(39.49±0.64)℃]、白细胞计数(WBC)[(14.92±11.78)×10^(9)/L]、中性粒细胞计数(NEU)[(13.39±11.60)×10^(9)/L]、单核细胞计数(MONO)[(0.72±0.36)×10^(9)/L]、NLR[(14.86±10.52)]、PLR[(199.15±160.69)]、PCT[(22.81±17.86)μg/L]、CRP[(133.44±63.63)mg/L]、FDP[(49.71±41.44)mg/L]、DDi[(16.56±12.20)mg/L]均高于尿路感染组[(37.12±1.20)℃、(9.04±3.95)×10^(9)/L、(6.25±4.02)×10^(9)/L、(0.42±0.29)×10^(9)/L、(3.67±3.34)、(120.01±44.08)、(4.46±8.69)μg/L、(39.22±22.16)mg/L、(3.81±3.41)mg/L、(0.84±0.75)mg/L],差异均有统计学意义(t=7.356、2.578、3.162、2.958、5.538、2.591、2.810、4.825、2.902、2.375,均P<0.05);而血流感染组的血小板(PLT)[(167.50±104.93)×10^(9)/L]、淋巴细胞计数(LYM)[(1.06±0.58)×10^(9)/L]、血钠[(130.89±6.50)mmol/L]、抗凝血酶Ⅲ[(57.88±16.28)%]均低于尿路感染组[(239.40±82.52)×10^(9)/L、(2.14±0.71)×10^(9)/L、血清钠(138.46±5.96)mmol/L,抗凝血酶Ⅲ(90.11±8.90)%)],差异均有统计学意义(t=-2.853、-6.313、-4.046、-7.350,均P<0.05);行PCT的相关分析:PCT与T(r=0.387)、WBC(r=0.355)、NEU(r=0.368)、CRP(r=0.605)、FDP(r=0.616)、DDi(r=0.486)均呈正相关(均P<0.05),与血清钠(r=-0.319)、抗凝血酶Ⅲ(r=-0.465)均呈负相关(均P<0.05),PCT的多元线性回归分析显示:FDP、T与PCT显著相关。结论经血流感染大肠埃希菌的2型糖尿病患者炎症指标PCT、T、WBC、NLR、CRP、FDP、DDi显著高于经尿路感染,而PCT与T及FDP均显著相关。

Objective To compare serum procalcitonin and fibrinogen degradation product levels between type 2 diabetes mellitus patients with Escherichia coli bloodstream and urinary tract infections.Methods The clinical data of 82 type 2 diabetes mellitus patients with Escherichia coli infections who received treatment between December 2014 and December 2019 in the First Affiliated Hospital of Datong University(The Fifth People's Hospital of Datong)were retrospectively analyzed.These patients were assigned to bloodstream infection(n=40)and urinary tract infection(n=42)according to the way of Escherichia coli infection.Serum procalcitonin and fibrinogen degradation product levels,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,C-reactive protein,white blood cell count,D-Dimer level,antithrombin III activity,and electrolytes were determined and compared between the two groups.Correlation between procalcitonin and other variables was analyzed.Multiple linear regression analysis was performed with procalcitonin level as a dependent variable and other relevant indexes as independent variables.Results Body temperature,white blood cell count,neutrophil count,monocyte count,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,procalcitonin level,C-reactive protein level,fibrinogen degradation product level,and D-Dimer level in the bloodstream injection group were(39.49±0.64)℃,(14.92±11.78)×10^(9)/L,(13.39±11.60)×10^(9)/L,(0.72±0.36)×10^(9)/L,(14.86±10.52),(199.15±160.69),(22.81±17.86)μg/L,(133.44±63.63)mg/L,(49.71±41.44)mg/L,(16.56±12.20)mg/L,respectively,which were significantly higher than those in the urinary tract infection group[(37.12±1.20)℃,(9.04±3.95)×10^(9)/L,(6.25±4.02)×10^(9)/L,(0.42±0.29)×10^(9)/L,(3.67±3.34),(120.01±44.08),(4.46±8.69)μg/L,(39.22±22.16)mg/L,(3.81±3.41)mg/L,(0.84±0.75)mg/L),t=7.356,2.578,3.162,2.958,5.538,2.591,2.810,4.825,2.902,2.375,all P<0.05].Platelet count,lymphocyte count,blood sodium level and antithrombinⅢactivity in the bloodstream infection group were(167.50±104.93)×10^(9)/L,(1.06±0.58)×10^(9)/L,(130.89±6.50)mmol/L,(57.88±16.28)%,which were significantly lower than those in the urinary tract infection group[(239.40±82.52)×10^(9)/L,(2.14±0.71)×10^(9)/L,(138.46±5.96)mmol/L,(90.11±8.90)%,t=-2.853,-6.313,-4.046,-7.350,all P<0.05].Correlation analysis revealed that serum procalcitonin level was positively correlated with body temperature(r=0.387),white blood cell count(r=0.355),neutrophil count(r=0.368),C-reactive protein(r=0.605),fibrinogen degradation product level(r=0.616),D-Dimer level(r=0.486)(all P<0.05),and it was negatively correlated with sodium level(r=-0.319)and antithrombinⅢactivity(r=-0.465)(both P<0.05).Multiple linear regression analysis results revealed that fibrinogen degradation product level and body temperature were greatly correlated with procalcitonin level.Conclusion Inflammatory indicators procalcitonin level,body temperature,white blood cell count,neutrophil count,C-reactive protein,fibrinogen degradation product level and D-Dimer level were remarkably higher in type 2 diabetes mellitus patients with Escherichia coli bloodstream infection than those in type 2 diabetes mellitus patients with Escherichia coli urinary tract infection.Procalcitonin level was greatly correlated with body temperature and fibrinogen degradation product level.