老年糖尿病并发深部真菌感染60例临床分析

目的:探讨老年糖尿病患者并发深部真菌感染的易感因素、临床表现及治疗方法。方法:对2002年1月至2007年1月住院的60例老年糖尿病并发深部真菌感染患者的临床资料进行回顾性分析。结果:60例均并发其他系统疾病,并原发肺部疾病54例,神经系统疾病30例,心血管疾病39例,慢性肾病15例,恶性肿瘤5例。临床表现无特异性。感染的部位依次为呼吸道、消化道、泌尿道及血液。主要病原菌为白色念珠菌,占真菌感染的75%。氟康唑为首选治疗药物。结论:老年糖尿病患者深部真菌感染常见,与高龄、长期住院、卧床、并发多种基础疾病、多种广谱抗生素及糖皮质激素的使用密切相关。严格控制血糖,积极治疗基础疾病,合理使用抗生素及联合抗真菌药物的治疗非常重要。

Analysis of 60 Old Diabetic Patients with Deep Fungal Infection

Objective:To investigate the susceptible factor,clinical manifestation and treatmeat of the old diabetic patients complicated with deep fungal infection.Methods:The clinical data of 60 diabetic patients with deep fungal infections from Jan.2002 to Dec.2007 in our hospital were reviewed retrospectively.The patients were age from 74 to 94 years.Results: All cases had underlying conditions,including primary pulmonary disease,neuropathy,cardiovascular disease,chronic nephropathy,malignant tumor etc.The clinical manifestation had no specialty.The sequences of infection sites were respiratory system,digestive system,urine system and blood.The main pathogenic fungal species was white candidacies fungus,which was 75% in all deep fungal infections.The fluconazole was the first choice of the treatmeat.Conclusion:The old diabetes with deep fungal infection are very common,corrected with senility,long term in hospital,sickbed,complicated with many underlying disease,usage of several broad-spectrum antibiotics and cortisol.To control blood sugar strictly,use antibiotics with antifungal drug correctly are very important.