糖尿病合并肺部真菌感染31例临床剖析.docVIP

糖尿病合并肺部真菌感染31例临床剖析 　　作者简介：高莉，生于1977年，硕士，主治医师，籍贯绵阳（621000），通讯作者：方向明，绵阳市中心医院内分泌科主任医师，【摘要】目的 探讨糖尿病合并肺部真菌感染的临床特点、危险因素、病原菌类型、药敏及预后。方法 对2011年1月至 2013年12月绵阳市中心医院内分泌科31例糖尿病合并肺部真菌感染住院病例进行回顾性分析。 结果 该组病例均为2型糖尿病患者，高龄患者居多，平均年龄77.4岁，糖尿病病程长，10年以上占67.74%，血糖控制差，糖化血红蛋白（HbA1c）10.8±1.9%，90%以上存在不同程度的低蛋白血症，尿蛋白显著增加。病原菌以酵母菌属为主，耐药率高。结论 糖尿病合并肺部真菌感染的临床表现无特异性，患者对糖尿病认识不足、治疗不正规所致高血糖和低蛋白血症是发生肺部真菌感染的重要危险因素。其发病呈上升趋势，且耐药率高，病死率高，应引起临床高度重视，重在预防。 　　【关键词】糖尿病； 肺部；真菌感染；临床分析 　　【Abstract】Objective To find out the clinical features , risk factors, types offungal infection, susceptibility and prognosis of diabetic patients with pulmonary fungal infection. Methods 31 cases of diabetic patients with pulmonary fungal infection from Jan 2011 to Dec 2013 in the Central Hospital of Mianyang were retrospectively analyzed. Results This group of cases were inpatients with type 2 diabetes，mostly in the elderly patients whith the average age of 77.4 years and long duration of diabetes(above 10 years accounted for 67.74%). All of them had poor blood sugar control, HbA1c 10.8±1.9%. More than 90% of them had different degree of hypoalbuminemia, and urine protein increased significantly. Blastocystis were showed mainly pathogenic mycetes type whith high clinical resistance. ConclusionAll the clinical manifestations of diabetic patients with pulmonary fungal infection were not specific. High blood sugar and hypoalbuminemia caused by lack of understanding of diabetes and informal treatment were important risk factors for pulmonary fungus infection. The morbidity is rising whith high resistance and high fatality rate. Clinicians should pay more attention to it, especially prevention. 　　【Abstract】【key words 】diabetes; lung ; fungal infection ; clinical analysis 　　【中图分类号】R726.12 【文献标识码】B【文章编号】1004-4949(2014)07-0001-01 　　 　　感染是糖尿病的常见并发症，同时也是引起糖尿病患者死亡的重要原因之一［1］。近年来糖尿病合并肺部真菌感染呈增多趋势，且耐药率高，【1-2】死亡率高，应引起临床高度重视。【3-4】为了提高对糖尿病合并肺部真菌感染的认识，我们应用回顾性调查的方法对绵阳市中心医院内分泌科2011年1月1日至2013年12月31日共31例糖尿病合并肺部真菌感染住院病例进行了分析。 　　1资料与方法 　　1.1 一般资料采