摘要
目的分析糖尿病合并脓毒症患者的临床特征及影响预后的危险因素。方法收集2014年1月1日-2015年12月31日住院治疗的40岁以上脓毒症患者454例临床资料,其中糖尿病脓毒症组(研究组)98例,非糖尿病脓毒症组(对照组)356例,比较两组患者临床基本资料及感染原发部位分布,并依据预后将糖尿病脓毒症患者分为死亡组和存活组,对其合并症、手术及操作等进行单因素卡方分析和多因素logistic回归分析。结果研究组和对照组在年龄、性别、平均住院费用上差异均无统计学意义,感染原发部位前3位依次是肺部感染、胆囊/胆道感染、尿路感染;研究组肝脓肿分布率(8.16%)和皮肤软组织分布率(9.18%)高于对照组(3.38%,3.66%,P<0.05),依据预后将糖尿病合并脓毒症分为死亡组(46例)和存活组(52例),死亡组年龄≥60岁、真菌感染、肺部感染、两个以上脏器衰竭、使用呼吸机比率均高于存活组,logistic回归结果显示,恶性肿瘤和使用呼吸机是糖尿病合并脓毒症死亡的危险因素(P<0.05)。结论糖尿病合并脓毒症未增加脓毒症患者住院天数、住院费用;但两组在原发感染部位构成方面有所不同,肝脓肿和皮肤软组织感染在糖尿病脓毒症组高于非糖尿病组,使用呼吸机和恶性肿瘤是糖尿病合并脓毒症患者死亡的独立的危险因素。
OBJECTIVE To investigate the clinical characteristics of diabetes mellitus complicated with sepsis and analyze the influencing factors for prognosis.METHODS The clinical data were collected from 454 patients with sepsis who were more than 40 years old and hospitalized for treatment from Jan 1,2014 to Dec 31,2015.Totally98 diabetes mellitus patients complicated with sepsis were assigned as the study group,and 356 non-diabetes mellitus patients complicated with sepsis were set as the control group.The baseline clinical data and primary infection sites were compared between the two groups of patients.The diabetes mellitus patients complicated with sepsis were divided into the death group and the survival group according to the prognosis.The univariate chi-square analysis and multivariate logistic regression analysis were performed for the complications,surgeries and operations.RESULTS There was no significant difference in the age,gender,or average hospitalization cost between the study group and the control group.The lungs,gall bladder/biliary tract and urinary tract ranked the top 3 primary infection sites.The distribution rate of liver abscess of the study group was 8.16% ,higher than 3.38% of the control group;the distribution rate of skin soft tissues of the study group was 9.18% ,higher than 3.66% of the control group（P〈0.05）.The diabetes mellitus patients complicated with sepsis were divided into the death group（46cases）and the survival group（52 cases）according to the prognosis.The proportions of the patients aged no less than60 years old,fungal infection,pulmonary infection,failure of more than two organs and use of ventilators were higher in the death group than in the survival group.The result of the logistic regression analysis indicated that the malignant tumor and use of ventilators were the risk factors for the death of the diabetes mellitus patients complicated with sepsis（P〈0.05）.CONCLUSIONThe diabetes mellitus complicated with sepsis does not lead to the increase of hospitalization duration or hospitalization cost.The two groups of patients vary in the constituent ratios of the primary infection sites,the proportions of the patients with liver abscess and skin soft tissue infection are higher in the diabetes mellitus sepsis group than in the non-diabetes mellitus group.The use of ventilators and malignant tumors are the independent risk factors for the death of the diabetes mellitus patients complicated with sepsis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第18期4147-4150,共4页
Chinese Journal of Nosocomiology
基金
新疆维吾尔自治区自然科学基金资助项目(2016D01C297)
关键词
中老年糖尿病
脓毒症
预后
Middle-aged diabetes mellitus
Sepsis
Prognosis
