2型糖尿病患者合并尿路感染的特点及其高危因素调查

Analysis on characteristics and high risk factors of type 2 diabetes mellitus with urinary tract infection

目的探讨2型糖尿病(T2DM)患者发生尿路感染(UTI)的特点及高危因素。方法对428例T2DM患者进行回顾性病例调查研究,以是否发生UTI将其分为感染组(62例)和未感染组(366例);分析T2DM患者的UTI发生率、症状及病原菌特点,筛选患者发生UTI的相关危险因素。结果 UTI发生率为14. 5%(62/428),感染以革兰阴性菌为主(77. 4%),其中大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌占前三位;多因素分析显示,影响T2DM患者发生UTI的危险因素包括年龄(OR=2. 074,95%CI:1. 164~3. 694)、病程(OR=3. 004,95%CI:1. 713~5. 267)、高血压(OR=4. 173,95%CI:2. 319~7. 509)、空腹血糖(OR=4. 603,95%CI:2. 599~8. 154)、白蛋白(OR=3. 410,95%CI:1. 948~5. 968)、既往UTI史(OR=2. 499,95%CI:1. 356~4. 604)等。结论 T2DM患者具有较高的UTI发生率,且部分呈现无症状尿路感染,感染以革兰阴性菌为主;应针对相关危险因素,采取针对性预防和治疗措施,降低T2DM患者的UTI发生率,改善预后。

Objective To explore the characteristics and high risk factors of type 2 diabetes mellitus(T2DM)with urinary tract infection(UTI).Methods Four hundred and twenty-eight cases of T2DM were carried out a case-control study,and the patients were divided into infection group(62 cases)and non-infection group(366 cases).The incidence rate of UTI,symptoms and characteristics of pathogenic bacteria were analyzed in the patients of T2DM with UTI,and the risk factors of UTI were screened.Results The incidence rate of UTI was 14.5%(62/428).Gram negative bacteria were the main pathogens(77.4%),and mainly in Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis.Multiple factors analysis results showed that the risk factors of UTI of T2DM patients contained age(OR=2.074,95%CI:1.164~3.694),course of disease(OR=3.004,95%CI:1.713~5.267),hypertension(OR=4.173,95%CI:2.319~7.509),fasting plasma glucose(OR=4.603,95%CI:2.599~8.154),albumin(OR=3.410,95%CI:1.948~5.968)and past medical history of UTI(OR=2.499,95%CI:1.356~4.604).Conclusion Patients with T2DM have a high incidence of UTI,and some of them presents asymptomatic urinary tract infection,the infection is mainly caused by gram-negative bacteria.To aim directly at these above risk factors,we should adopt targeted prevention and treatment measures to reduce the incidence rate of UTI and improve the prognosis.