文章摘要
甘新宇,刘思瑾,张俊.缺血性脑卒中合并2型糖尿病患者伴发尿路感染危险因素的回顾性分析[J].中华物理医学与康复杂志,2022,44(8):727-731
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缺血性脑卒中合并2型糖尿病患者伴发尿路感染危险因素的回顾性分析
  
DOI:10.3760/cma.j.issn.0254-1424.2022.08.013
中文关键词: 2型糖尿病  缺血性脑卒中  尿路感染  危险因素  回顾性研究
英文关键词: Diabetes  Ischemic stroke  Urinary tract infections
基金项目:
作者单位
甘新宇 哈尔滨医科大学第五临床医学院大庆 163000 
刘思瑾 哈尔滨医科大学护理学院大庆 163000 
张俊 哈尔滨医科大学第五临床医学院大庆 163000
北大荒集团总医院康复医学科哈尔滨 150000 
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中文摘要:
      目的 探讨缺血性脑卒中合并2型糖尿病患者发生尿路感染的危险因素,为临床早期防治尿路感染提供参考依据。 方法 采用回顾性分析方法,选取首次缺血性脑卒中合并既往2型糖尿病患者459例。根据是否发生尿路感染,分为感染组(149例)和非感染组(310例)。采用单因素分析两组患者的一般资料及实验室指标,包括年龄、性别、缺血性脑卒中类型、身体质量指数(BMI)、冠心病史、糖化血红蛋白(HbAlc)、血清白蛋白(ALB)、血清葡萄糖(GLU)等;采用二元Logistic回归法分析缺血性脑卒中合并2型糖尿病患者伴发尿路感染的危险因素。 结果 共有149例患者(32.5%)发生尿路感染。单因素分析显示,性别、年龄、吸烟、饮酒、缺血性脑卒中类型、合并冠心病、BMI、HbA1c含量、ALB含量可能与发生尿路感染有关(P<0.05);二元Logistic回归分析显示,女性[OR=13.917,95%CI(7.061,27.431),P<0.001]、HbA1c≥6.5%[OR=2.425,95%CI(1.397,4.209),P=0.002]、ALB<40g/L[OR=2.071,95%CI(1.207,30552),P=0.008]、肥胖(BMI≥28.0 kg/m2)[OR=2.240,95%CI(1.183,4.241),P=0.013]、非腔隙性脑梗死[OR=2.649,95%CI(1.639,4.280),P<0.001]是缺血性脑卒中合并2型糖尿病后尿路感染的危险因素。 结论 缺血性脑卒中合并2型糖尿病患者尿路感染的发生率较高,女性、肥胖、高HbA1c水平、低ALB水平、非腔隙性脑梗死是其并发尿路感染的危险因素。未来可针对以上危险因素进一步采取综合性治疗措施,降低尿路感染的发生率,提高患者的生活质量。
英文摘要:
      Objective To explore the risk factors for urinary tract infection (UTI) among type 2 diabetics after an ischemic stroke. Methods A total of 459 survivors of a first ischemic stroke who had type 2 diabetes were studied retrospectively. The 149 who had contracted a urinary tract infection (32.5%) formed the infections group; the other 310 were the no-infections group. Univariate analysis was applied to the subjects′ ages, sex, type of ischemic stroke, body mass index (BMI), history of coronary heart disease, glycosylated hemoglobin (HbAlc) levels, serum albumin (ALB) levels and serum glucose (GLU) levels. The risk factors for urinary tract infection for such patients were analyzed using binary logistic regression. Results The univariate analysis showed that gender, age, smoking, drinking, type of ischemic stroke, coronary heart disease, as well as BMI, HbAlc and ALB levels were correlated with UTI. In the binary logistic regression analysis the significant predictors were being female, HbAlc≥6.5%, serum albumin<40g/L, obesity (BMI≥28.0kg/m2) and the type of ischemic stroke. Conclusions Ischemic stroke survivors with type 2 diabetes mellitus are at high risk of UTI. Being female and/or obese, a high HbAlc level, a low ALB level, and certain types of ischemic stroke are all risk factors. These findings should provide a basis for the prevention and treatment of UTIs after a stroke.
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