CHANGES IN INFLAMMATORY FACTORS IN SERUM AND BRONCHOALVEOLAR LAVAGE FLUID WITH DIFFERENT PATHOGENIC BACTERIA AND THEIR CLINICAL SIGNIFICANCE IN PATIENTS WITH DIABETES COMPLICATED BY SEVERE PULMONARY INFECTION
Objective To investigate the changes in inflammatory factors in serum and bronchoalveolar lavage fluid with different pathogenic bacteria and their clinical significance in patients with diabetes complicated by severe pulmonary infection.Methods A total of 132 patients with diabetes complicated by severe pulmonary infection who were admitted to our hospital from January 2016 to April in 2017 were enrolled.According to the pathogenic bacteria in serum and bronchoalveolar lavage fluid,the patients were divided into Gram-positive group,Gram-negative group,and fungal group;according to the clinical outcome,the patients were divided into death group and survival group.A continuous glucose monitoring system was used for the monitoring of blood glucose every 2-4 hours,and the standard deviation of blood glucose (SDBG) was calculated.The changes in inflammatory factors in serum and bronchoalveolar lavage fluid with different pathogenic bacteria were observed,including interleukin-6,interleukin-8,tumor necrosis factor-α,and C-reactive protein.The APACHEⅡ score,time to reach blood glucose control target,SDBG,and hypoglycemic events were compared between the patients with different outcomes.Results On days 1 and 7 of hospitalization,the Gram-negative group had the highest levels of inflammatory factors in serum and bronchoalveolar lavage fluid,followed by the Gram-positive group and the fungal group,and there were significant differences between the three groups (F =7.043-19.635,P＜0.05).On day 7 of hospitalization,the patients with infection caused by the same pathogenic bacteria had significant reductions in the levels of inflammatory factors in serum and bronchoalveolar lavage fluid (t =4.67-11.16,P ＜ 0.05).There were no significant differences in the constituent ratios of infections caused by Gram-negative and Gram positive bacteria between the death group and the survival group (P＞0.05),while there was a significant difference in the constituent ratio of fungal infection (x2 =25.097,P＜0.05).The logistic regression analysis of influencing factors for death showed that APACHE Ⅱ score (OR=2.342),SDBG (OR-1.458),and fungal infection (OR=3.689) were independent risk factors for death.Conclusion Blood glucose control for patients with diabetes complicated by severe pulmonary infection can reduce blood glucose fluctuation throughout the day,avoid and control fungal infection,and bring benefits to patients' prognosis.
NETL
NSTL
万方数据
维普
