摘要
目的探讨老年糖尿病患者医院感染病原学特征及血清白细胞介素-6(IL-6)、降钙素原(PCT)检测的临床意义。方法选取浙江新安国际医院2017年4月-2018年10月收治的700例糖尿病患者为研究对象,回顾性分析患者医院感染发生率、感染部位及病原学特点,测定患者血清IL-6、PCT水平,并采用受试者工作特征曲线(ROC)分析两指标诊断患者发生感染的临床价值。结果 700例糖尿病患者共有99例发生感染,发生率为14.14%,其中呼吸道疾病、泌尿道感染分别占36.36%、21.21%;感染患者共检出病原菌151株,其中革兰阴性菌110株占72.85%、革兰阳性菌33株占21.85%、真菌8株占5.30%;感染组患者血清IL-6(25.51±3.05)ng/L、PCT(12.17±3.50)ng/L水平均高于未感染组(P<0.05);血清IL-6、PCT联合检测诊断糖尿病合并感染的ROC曲线下面积为0.959,大于IL-6、PCT单独检测。结论老年糖尿病患者医院感染以呼吸道感染为主,感染病原菌主要为革兰阴性菌,血清IL-6、PCT水平升高,二者联合检测可作为糖尿病患者感染评估的敏感指标。
OBJECTIVE To explore the etiological characteristics of nosocomial infection in the elderly patients with diabetes mellitus and analyze the clinical significance of serum interleukin-6(IL-6)and procalcitonin(PCT).METHODS A total of 700 patients with diabetes mellitus who were treated in Xin′an International Hospital from Apr 2017 to Oct 2018 were recruited as the study subjects.The incidence of nosocomial infection,infection sites and etiological characteristics were retrospectively analyzed,the levels of serum IL-6 and PCT were determined,and the clinical value of the two indexes in diagnosis of infection was analyzed by using receiver operating characteristic(ROC)curve.RESULTS Of the 700 patients with diabetes mellitus,99 had infection,with the incidence rate 14.14%,36.36%of whom had respiratory tract infection,and 21.21%had urinary tract infection.Totally 151 strains of pathogens were isolated from the patients with infection,110(72.85%)of which were gram-negative bacteria,33(21.85%)were gram-positive bacteria,and 8(5.30%)were fungi.The levels of serum IL-6 and PCT of the infection group were respectively(25.51±3.05)ng/L and(12.17±3.50)ng/L,significantly higher than those of the non-infection group(P<0.05).The area under ROC curve of the joint detection of serum IL-6 and PCT was 0.959 in diagnosis of the infection in the diabetes mellitus patients,greater than that of the single detection of IL-6 or PCT.CONCLUSION The patients with respiratory tract infection are dominant among the elderly diabetes mellitus patients with nosocomial infection,the gram-negative bacteria are the predominant pathogens causing the infection.The levels of serum IL-6 and PCT are elevated,and the joint detection of the two indexes can be served as sensitive indexes for assessment of the infection in the diabetes mellitus patients.
作者
李政球
王适龙
鲍小强
陈春洁
王丽娜
LI Zheng-qiu;WANG Shi-long;BAO Xiao-qiang;CHEN Chun-jie;WANG Li-na(Xi'an International Hospital,Jiaxin,Zhejiang 314000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第1期6-9,共4页
Chinese Journal of Nosocomiology
关键词
糖尿病
医院感染
病原学
白细胞介素-6
降钙素原
Diabetes mellitus
Nosocomial infection
Etiology
Interleukin-6
Procalcitonin
