肺部感染对糖尿病肾病维持性血液透析患者的影响及病原菌分布

发布时间：2018-03-09 11:54

  本文选题：肺部感染　切入点：糖尿病肾病　出处：《中华医院感染学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的分析肺部感染对糖尿病肾病维持性血液透析患者的影响,并检测病原菌分布及构成比。方法分析2015年1月-2016年12月在医院接受维持性血液透析的糖尿病肾病患者的临床资料,依据透析治疗期间是否并发肺部感染分为感染组58例及未感染组64例,另纳入50例同期行健康体检者作为对照组;分析感染组患者呼吸道病原菌分布,对比各组血清学指标,包括:白介素-17(IL-17)、白介素-1β(IL-1β)、超氧化物歧化酶(SOD)及丙二醛(MDA);对比肺功能相关指标,包括:FEV1、FVC、FEV1/FVC及FEV1%。结果 58例感染组患者呼吸道分泌物中共分离出病原菌69株,其中革兰阳性菌41株占59.42%;革兰阴性菌24株占34.78%;真菌4株占5.80%;感染组患者外周血IL-17、IL-1β及MDA水平均显著高于对照组及未感染组,差异均有统计学意义(P0.05);感染组患者外周血SOD水平显著低于未感染组及对照组(P0.05);感染组患者的FVC、FEV1、FEV1%及FEV1/FVC水平均显著低于未感染组患者及对照组,差异均有统计学意义(P0.05)。结论肺部感染可降低接受维持性血液透析的糖尿病肾病患者的肺功能,加剧系统性氧化应激及炎症反应。
[Abstract]:Objective to analyze the effect of pulmonary infection on maintenance hemodialysis patients with diabetic nephropathy. Methods the clinical data of diabetic nephropathy patients undergoing maintenance hemodialysis from January 2015 to December 2016 were analyzed. According to whether pulmonary infection was complicated during dialysis treatment, it was divided into infection group (n = 58) and uninfected group (n = 64), and 50 healthy persons were included as control group, the distribution of respiratory pathogenic bacteria in infected group was analyzed, and the serological indexes were compared. Results 69 strains of pathogenic bacteria were isolated from respiratory secretions of 58 infected patients, including IL-17, IL-17, SOD, SOD) and malondialdehyde (MDAA), and compared with lung function related indexes, including FEV1 / FVCFEV1 / FVC and FEV1 / FVC, respectively. Among them, 41 strains of Gram-positive bacteria accounted for 59.42%, 24 strains of Gram-negative bacteria accounted for 34.78% and 4 strains of fungi accounted for 5.80%. The levels of IL-17 IL-1 尾 and MDA in peripheral blood of infected patients were significantly higher than those of control group and non-infected group. The levels of SOD in peripheral blood of the infected group were significantly lower than those of the uninfected group and the control group, and the levels of FEV1% and FEV1/FVC in the infected group were significantly lower than those in the uninfected group and the control group. Conclusion Pulmonary infection can reduce the pulmonary function of diabetic nephropathy patients undergoing maintenance hemodialysis and aggravate systemic oxidative stress and inflammatory reaction.
【作者单位】： 攀枝花市中西结合医院内分泌科;攀枝花市中西结合医院肾内科;
【基金】：四川省卫生厅基金资助项目(20160423)
【分类号】：R563.1;R587.2;R692.9

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