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Diabetes Care：糖尿病增加多种感染发生风险

2019-10-23 国际糖尿病编辑部 国际糖尿病

糖尿病感染流感败血症
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根据发表在Diabetes Care上的研究结果，与没有糖尿病的成人相比，患有糖尿病的成人发生流感、蜂窝织炎和败血症等感染的风险更高。美国疾病控制与预防中心糖尿病转化部门Jessica L. Harding博士及其同事在研究报告中写道，糖尿病患者数量增加可能会导致未来感染人数增多，这将对医疗负担和患者管理产生重要影响。卫生保健提供者需要认识到糖尿病是感染的一个重要危险因素，这可能有助于改善患者管理

根据发表在Diabetes Care上的研究结果，与没有糖尿病的成人相比，患有糖尿病的成人发生流感、蜂窝织炎和败血症等感染的风险更高。

美国疾病控制与预防中心糖尿病转化部门Jessica L. Harding博士及其同事在研究报告中写道，糖尿病患者数量增加可能会导致未来感染人数增多，这将对医疗负担和患者管理产生重要影响。卫生保健提供者需要认识到糖尿病是感染的一个重要危险因素，这可能有助于改善患者管理。

研究者根据美国国家健康调查信息，估算了2000~2015年美国患有和未患糖尿病的成人数量。他们还根据全国住院患者样本数据和诊断代码，确定了同一时期因感染而住院的人数。

总体感染风险

与未患糖尿病的成人相比，患糖尿病的成人因感染而住院的比例更高（RR=3.8；95%CI：3.8~3.8）。此外，成人糖尿病患者发生肺炎（RR=2.6；95%CI：2.6~2.6）、流感（RR=3.3；95%CI：3.3~3.4）、急性支气管炎和细支气管炎（RR=3.7；95%CI：3.7~3.8）、肾脏感染（RR=4.3；95%CI：4.3~4.4）、蜂窝织炎（RR=6.9；95%CI：6.9~6.9）、足部感染（RR=14.7；95%CI：14.6~14.8）、骨髓炎（RR=15.7；95%CI：15.5~15.8）、真菌感染（RR=2.8；95%CI：2.8~2.8）、术后创面感染（RR=3.2；95%CI：3.2~3.2）和脓毒症（RR=3.2；95%CI：3.2~3.2）的概率均更高。

研究者还发现，2015年成人糖尿病患者因感染而住院的比例为68.7‰，高于2000年的63.1‰。相比之下，没有糖尿病的成人上述比例分别为16.3‰和15.5‰。2008年以后，没有糖尿病的成人这一比例显著降低了7.9%，而在成人糖尿病患者中并未见降低。

不同年龄和感染类型的差异

与2000年相比，2015年流感、肾脏感染、蜂窝织炎、骨髓炎和败血症的发生率上升，而术后创面感染和急性支气管炎或细支气管炎的发生率下降。

在18~44岁的成人糖尿病患者中，2015年和2000年因感染而住院的比例分别为63.1‰和42.1‰（P<0.0001）；在≥75岁的糖尿病患者中，上述比例分别为131.7‰和169.5‰（P<0.0001）。2000~2008年，65~74岁的成人糖尿病患者中因感染而住院的比例没有显著改变，但2015年和2008年上述比例分别为72.9‰和88.9‰（P<0.001）；在45~64岁的成人糖尿病患者中，这一比例没有变化，而且糖尿病患者感染类型的模式基本相似。

研究者总结道，该研究结果表明，需要加强公共卫生和医疗措施，以预防需要住院治疗的成人糖尿病患者发生感染。这项研究强调了在成人糖尿病患者，特别是年轻糖尿病患者中，需要更大程度地降低感染风险因素。

原始出处：
Jessica L. Harding, Stephen R. Benoit, Edward W. Gregg, et al. Trends in Rates of Infections Requiring Hospitalization Among Adults With Versus Without Diabetes in the U.S., 2000–2015. Diabetes Care. Oct 2019 . 

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    2019-10-24 misszhang

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    2019-10-23 1209e435m98(暂无昵称)

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