糖尿病伴侵袭性肺曲霉菌病的临床特点及危险因素分析

发布时间：2018-04-01 00:27

本文选题：糖尿病　切入点：侵袭性肺曲霉菌病　出处：《中国糖尿病杂志》2017年11期

【摘要】：目的观察糖尿病伴侵袭性肺曲霉菌病(IPA)的临床特点并分析其危险因素。方法选取糖尿病伴IPA患者(DM+IPA组)38例和单纯糖尿病患者(DM组)40例。收集两组临床资料及生化指标。Logistic回归分析糖尿病伴IPA的危险因素。结果 (1)DM+IPA组以咳嗽、咳痰(42.11%),发热(42.11%)为主要临床表现,CT检查常可见薄壁空洞伴空气"新月征"(39.47%)和周围"晕轮征"(34.21%)。予抗真菌治疗,治疗总有效率为57.89%,病死率为28.95%;(2)DM+IPA组病程[(13.37±2.14)vs(11.42±2.25)年]、FPG[(17.84±3.15)vs(7.52±1.84)mmol/L]、2hPG[(22.90±4.63)vs(9.71±2.75)mmol/L]、HbA1c[(9.03±2.65)%vs(7.30±2.22)%]、血沉(ESR)[(94.62±31.49)vs(16.57±4.16)mm/h]、C-RP[(55.42±30.19)vs(1.67±0.22)mg/L]、降钙素原(PCT)[(1.20±1.10)vs(0.07±0.05)ng/ml]及D-二聚体水平[(475.81±183.62)vs(320.34±105.11)μg/ml]均高于DM组(P0.05或P0.01);(3)Logistic回归分析显示,年龄、糖尿病病程、FPG、HbA1c是糖尿病伴IPA的危险因素(P0.05或P0.01)。结论糖尿病伴IPA患者病情严重,治愈率低,病死率高,以咳嗽、咳痰、发热为主要表现,以"新月征""晕轮征"为影像学特点。高龄、病程长、血糖控制差可能是糖尿病伴IPA的危险因素。
[Abstract]:Objective to observe the clinical characteristics of diabetes mellitus with invasive pulmonary aspergillosis and analyze its risk factors. Methods 38 patients with diabetes mellitus with IPA and 40 patients with diabetes mellitus with diabetes mellitus were selected. Logistic regression analysis was used to analyze the risk factors of diabetes mellitus with IPA. The main clinical manifestation was the thin wall cavity with air "crescent sign" (39.47) and the surrounding "halo sign" (34.21%). Antifungal treatment was given. The total effective rate was 57.89, the mortality rate was 28.95 卤2DM IPA [13.37 卤2.14)vs(11.42 卤2.25] FPGs [17.84 卤3.15)vs(7.52 卤1.84)mmol/L] 2hPG [22.90 卤4.63)vs(9.71 卤2.75)mmol/L] HbA1c [9.03 卤2.65)%vs(7.30 卤2.2222%], ESR] [94.62 卤31.49)vs(16.57 卤4.16)mm/h] C-RP [55.42 卤30.19)vs(1.67 卤0.22)mg/L], procalcitonin [1.20 卤1.10)vs(0.07 卤0.05)ng/ml] and D-dimer levels [475.81 卤183.62)vs(320.34 卤105.11 渭 g/ml] were higher than those in DM group (P0.05 or P0.013Logistic logistic regression analysis). HbA1c was a risk factor for diabetes mellitus with IPA (P0.05 or P0.01). Conclusion Diabetes mellitus with IPA has a severe condition, low cure rate and high mortality rate. Cough, expectoration and fever are the main manifestations. Old age, long course of disease and poor control of blood glucose may be the risk factors of diabetes mellitus with IPA.
【作者单位】：南阳市中心医院呼吸内科;南阳医学高等专科学校;
【分类号】：R519;R587.1

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