摘要
目的探讨2型糖尿病(T2DM)伴活动性肺结核患者合并肺部感染的病原学特点,及CD64指数、S100A9对肺部细菌感染的诊断价值。方法选取2015年6月-2018年11月本院收治的75例T2DM伴肺结核患者,采集痰液标本进行病原菌的分离鉴定,根据感染情况分为感染组和未感染组,比较两组患者的CD64指数、S100A9;采用Logistic回归分析合并肺部感染的影响因素;采用ROC曲线分析CD64指数、S100A9对肺部细菌感染的诊断价值。结果75例T2DM伴活动性肺结核患者中并发感染56例(74.67%),共检测出78株病原菌,其中革兰阳性菌36株,革兰阴性菌42株。主要感染病原菌为肺炎链球菌(16株),肺炎克雷伯菌(15株)和金黄色葡萄球菌(14株)。感染组和非感染组患者的空腹血糖、CD64指数以及S100A9水平差异均有统计学意义(均P<0.05)。Logistic回归分析显示空腹血糖水平、CD64指数以及S100A9均是T2DM伴活动性肺结核患者发生细菌感染的独立危险因素(均P<0.05)。ROC曲线分析CD64指数以及S100A9诊断T2DM伴活动性肺结核患者合并细菌感染的截断值分别为3.24和12.58mg/ml,曲线下面积分别为0.809(95%CI=0.714~0.904)和0.788(95%CI=0.670~0.907)。结论CD64指数和S100A9是T2DM伴活动性肺结核患者合并肺部感染的危险因素,CD64指数和S100A9作为诊断指标具有一定临床鉴别意义。
Objective To investigate the etiological characteristics of patients with T2DM with active pulmonary tuberculosis complicated with pulmonary infection,and the diagnostic value of CD64index and S100A9for pulmonary bacterial infection.Methods 75cases of T2DM with pulmonary tuberculosis admitted to our hospital from June 2015to November 2018were selected,sputum specimens of the patients were collected and pathogenic bacteria were isolated and identified.According to the infection status,they were divided into infected group and non-infected group.The CD64index and S100A9of the two groups of patients were compared.Logistic regression was used to analyze the influencing factors of lung infection,and the ROC curve was used to analyze the diagnostic value of CD64index and S100A9on lung bacterial infection.Results Among 75T2DM patients with active tuberculosis,56cases(74.67%)were concurrently infected.A total of 78pathogens were detected,of which 36were gram-positive bacteria and 42were gram-negative bacteria.The main infectious pathogens were 16strains of Streptococcus pneumoniae,15strains of Klebsiella pneumoniae,and 14strains of Staphylococcus aureus.The differences in fasting blood glucose,CD64index and S100A9levels between the infected group and the non-infected group were statistically significant(P<0.05).Logistic regression analysis showed that fasting blood glucose,CD64index and S100A9were independent risk factors for bacterial infection in patients with T2DM and active tuberculosis.ROC curve analysis showed that the cut-off values of CD64index and S100A9for diagnosis of T2DM with active tuberculosis patients with bacterial infection were 3.24and 12.58mg/mL,respectively,and the area under the curve were 0.809(95%CI=0.714-0.904)and 0.788(95%CI=0.670-0.907).Conclusion The CD64index and S100A9 are the risk factors for pulmonary infection in patients with T2DM with active tuberculosis.The CD64index and S100A9 as diagnostic indicators have certain clinical differential significance.
作者
刘懿
谢炎红
郑如添
屈莹莹
李妍
LIU Yi;XIE Yan-hong;ZHENG Ru-tian;QU Ying-ying;LI Yan(Department of Infection,Huizhou Central People's Hospital,Huizhou,Guangdong516001,China;Guangzhou Jinyu Medical Laboratory Center;Department of Hospital Infection Management,Huizhou Central People's Hospital)
出处
《中国病原生物学杂志》
CSCD
北大核心
2022年第2期229-232,共4页
Journal of Pathogen Biology
