老年糖尿病尿路感染76例临床分析

目的探讨我院近3 年收治的老年糖尿病尿路感染的临床资料特点. 方法对2001年1月～2003年12月我院所确诊76例老年糖尿病尿路感染患者与同期38例老年非糖尿病尿路感染患者进行对照研究. 结果老年糖尿病组尿路感染发生率明显增高,占66.9%,以女性更为明显(P＜0.01);老年糖尿病组无症状菌尿(ASB),上尿路和复杂性尿路感染及并发症发生率明显增高,分别为28.9%、47.6%、39.5%和7.9%;两组对比,差异有显著性(P＜0.01);细菌培养结果显示糖尿病组的真菌发生率高22.4%,耐药菌有所上升. 结论老年糖尿病尿路感染发生率高,多为ASB、上尿路和复杂性尿路感染,其并发症发生率相对较高;积极降低血糖的基础上,采用抗生素和非抗生素治疗和预防,尤其重视ASB的治疗,是减少或控制老年糖尿病尿路感染的有效方法.

Urinary Tract Infections among Old Patients with Diabetes Mellitus:A Clinical 76 Case Analysis

OBJECTIVE To investigate the clinical manifestation of bacterial urinary tract infections among old (patients) with diabetes in recent three years. METHODS A contrast analysis of clinical features was performed on urinary tract infections in old patients between 76 cases with diabetes and 38 cases without it diagnosed during 2001 to 2003. RESULTS The urinary tract infection rate in diabetes group was higher (66%, P<0.01), (especially) in female patients. The rate of asymptomatic bacteriuria (ASB, 28.9%), upper urinary tract infection (47.6%), complicated urinary tract infection (39.5%) and complications (7.9%) in diabetes group were all higher than non-diabetes one (P<0.01). The results of bacterial culture indicated that the fungal infection rate and drug resistance were higher in diabetes group. CONCLUSIONS The urinary tract infection rate and (complications) rate in old patients with diabetes are high. The infections mainly include ASB, upper urinary tract infection and complicated urinary tract infection. The key to reduce the urinary tract infection in old patients with diabetes is to take measures on ASB at the basis of controlling blood glucose.