知识与财富的链接
目的分析糖尿病与非糖尿病患者合并社区获得性肺炎的临床特点。方法选取2008年1月-2011年5月在某院住院的社区获得性肺炎患者100例,其中糖尿病患者50例（A组）,非糖尿病患者50例（B组）,对其病历资料进行回顾性分析。结果A组病程常迁延,平均住院时间为（18.52±4.32）d,较B组（12.64±4.18）d长,两组差异有统计学意义（χ2=6.92,P＜0.01）;A组患者肝功能多受损：血清丙氨酸转氨酶（ALT）为（52.26±15.18）U/L、天门冬氨酸转氨酶（AST）为（48.44±10.25） U/L,显著高于B组的ALT、AST［分别为（40.39±15.42）U/L、（35.70±9.98）U/L］（P＜0.05）;A组患者肾功能减退,血尿素氮（BUN）和血清肌酐（SCr）分别为（8.02±2.12）mmol/L、（128.05±21.25）μmol/L,显著高于B组的BUN和SCr［分别为（5.35±1.99） mmol/L、（98.20±20.93）μmol/L］（P＜0.05）。A组混合感染发生率为26.00%,显著高于B组的10.00%;代谢综合征和大血管并发症发生率分别为28.00%、36.00%,明显高于B组的12.00%、10.00%,差异均有统计学意义（均P＜0.05）。A组发展为重症肺炎的比率和病死率分别为12.00%（6例）、6.00%（3例）,B组分别为4.00%（2例）、2.00%(1例)。A组痰培养阳性41例（82.00％, 41/50）,B组痰培养阳性44例（88.00％,44/50）,两组检出病原体均以肺炎链球菌（A组16株,B组17株）、肺炎克雷伯菌（A组4株,B组5株）较多。结论糖尿病合并社区获得性肺炎病程长,病情重,合并症多;控制血糖是治疗的基础,抗感染是关键,改善营养和器官功能状态是重要的环节。
ObjectiveTo analyze clinical characteristics of community acquired pneumonia （CAP）in diabetic and non diabetic patients.MethodsFrom January 2008 to May 2011,100 CAP patients in a hospital were selected, 50 of whom had diabetes （group A） and 50 without diabetes （group B）, their clinical data were analyzed.ResultsThe average length of hospital stay in group A was significantly longer than that of group B （[18.52±4.32] d vs [12.64±4.18] d, X2=6.92,P〈0.01）; serum alanine aminotransferase （ALT） and aspartate transaminase （AST）in group A were significantly higher than group B （[52.26±15.18] U/L vs [40.39±15.42] U/L; [48.44 ±10.25] U/L vs [35.70±9.98] U/L, P〈0.05, respectively）; blood urea nitrogen （BUN） and serum creatinine （SCr） in group A were significantly higher than group B （[8.02±2.12] mmol/L vs [5.35±1.99] mmol/L; [128.05±21.25]μmol/L vs [98.20±20.93） μmol/L, P 〈0.05, respectively）. Mixed infection rate in group A was significantly higher than group B （26.00% vs 10.00%）; metabolic syndrome and incidence of macrovascular complications were significantly higher than group B （28.00% vs 12.00%; 36.00% vs 10.00%, P〈0.05, respectively）. Rate of severe pneumonia and mortality in group A was 12.00% （6 cases） and 6.00% （3 cases） respectively,and group B was 4.00% （2 cases） and 2.00% （1 case） respectively, sputum culture positive rate in group A and B was 82.00% （41/50） and 88.00% （44/50） respectively, Streptococcus pneumoniae （16 isolates in group A and 17 in group B） and Klebsiella pneumoniae （4 isolates in group A and 5 in group B）were common in both groups.ConclusionDiabetic patients with CAP have long disease course, with severe illness and multiple complications, controlling blood glucose is the basis of treatment, anti infection is the key, and improving nutritional state and organ function is important aspect.
