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

Efficacy of Insulin Pump and Tigecycline in the Treatment of Type 2 Diabetes Mellitus(T2DM) Combined with Extensively Drug-resistant Acinetobacter Baumannii Pneumonia

目的研究2型糖尿病(T2DM)伴广泛耐药鲍氏不动杆菌(MDRAB)肺炎患者行胰岛素泵+替加环素治疗的效果。方法选取宁德师范学院附属宁德市医院2019年1月—2021年5月收治的90例T2DM伴MDRAB肺炎患者,"硬币分组法"分参照组(胰岛素泵+头孢哌酮舒巴坦,n=45)、联合组(胰岛素泵+替加环素,n=45),比较分析两组的血清学指标、血糖指标、治疗效果及并发症。结果治疗前比较两组血清学指标、血糖指标差异无统计学意义(P>0.05);治疗后与参照组比较,联合组CGRP指标更高,WBC、ET及CRP指标更低;FPG、2 hPG及HbA1c指标更低,差异有统计学意义(P<0.05)。联合组有效率(97.78%)高于参照组(82.22%),联合组并发症率(4.44%)低于参照组(22.22%),差异有统计学意义(P<0.05)。结论提供胰岛素泵与替加环素治疗可控制血糖水平,彻底清除细菌、减缓患者不适症状,有效改善机体血清水平、降低并发症风险,可达到预期治疗效果,避免机体发生糖尿病肾病、肺源性心脏病等并发症。

Objective To study the effect of insulin pump plus tigacycline on type 2 diabetes mellitus(T2DM) patients with extensively drug-resistant Acinetobacter baumannii(MDRAB) pneumonia. Methods Selected 90 patients with T2DM with MDRAB pneumonia admitted to the Ningde Hospital Affiliated to Ningde Normal University from January 2019 to May 2021. The "coin grouping method" is divided into the reference group(insulin pump + cefoperazone and sulbactam, n=45)and the combination group(insulin pump + tigecycline, n=45). Comparied and analyzed of serum indexes, blood glucose indexes, treatment effects and complications of the two groups. Results There was no statistically significant difference in serum index and blood glucose index between the two groups before treatment(P>0.05);compared with the reference group after treatment, the combination group had higher CGRP indexes, and lower WBC, ET and CRP indexes;the indicators of FPG, 2 hPG and HbA1c are lower, the difference was statistically significant. The effective rate of the combined group(97.78%) was higher than that of the reference group(82.22%), and the complication rate(4.44%) of the combined group was lower than that of the reference group(22.22%), the difference was statistically significant(P <0.05). Conclusion Providing insulin pump and tigecycline treatment can control blood sugar levels, completely eliminate bacteria, alleviate patients’ discomfort symptoms, effectively improve the body’s serum levels and reduce the risk of complications. It can achieve the expected therapeutic effect and avoid complications such as diabetic nephropathy and cor pulmonale in the body.