190例口腔颌面部间隙感染合并高血糖患者回顾分析

doi:10.19438/j.cjoms.2023.04.007

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (4): 360-365.doi: 10.19438/j.cjoms.2023.04.007

190例口腔颌面部间隙感染合并高血糖患者回顾分析

杨佐谊, 叶蕾, 郑凌艳, 陈昌钰, 傅稼耀

上海交通大学医学院附属第九人民医院口腔外科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011

收稿日期:2022-12-03 修回日期:2023-03-05 出版日期:2023-07-20 发布日期:2023-08-16
通讯作者: 郑凌艳,E-mail: zhenglingyan1973@163.com
作者简介:杨佐谊（1997-）,女,在读硕士研究生,E-mail: yangzuoyi0123@163.com
基金资助:
国家自然科学基金（82170976,82201086,82001064）; 上海交通大学医学院附属第九人民医院生物样本库项目（YBKB202107）

Retrospective analysis of 190 cases of oral and maxillofacial space infection complicated with hyperglycemia

YANG Zuo-yi, YE Lei, ZHENG Ling-yan, CHEN Chang-yu, FU Jia-yao

Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China

Received:2022-12-03 Revised:2023-03-05 Online:2023-07-20 Published:2023-08-16

摘要/Abstract

摘要： 目的：分析口腔颌面部间隙感染（oral and maxillofacial space infection, OMSI）合并糖尿病、应激性高血糖及血糖正常患者之间一般资料、临床表现、实验室检查及感染的优势菌群之间的差异。方法：收集2020年8月—2022年6月就诊于上海交通大学医学院附属第九人民医院口腔外科的190例OMSI患者进行回顾性分析。根据血糖的差异分成糖尿病组、应激性高血糖组及正常组。比较3组患者的流行病学、临床资料及实验室相关检查的差异。采用SPSS 25.0软件包对数据进行统计学分析。结果：糖尿病组与应激性高血糖组之间淋巴细胞绝对数、钠、氯之间具有显著差异;糖尿病组与血糖正常组之间年龄、中性粒细胞绝对数、中性粒细胞百分数、淋巴细胞百分数、C反应蛋白、 IL-6、IL-8、肿瘤坏死因子α、降钙素原、尿素、血清尿酸、纤维蛋白原、钠、氯、总二氧化碳之间具有显著差异;应激性高血糖组与血糖正常组之间中性粒细胞百分数、淋巴细胞百分数、淋巴细胞绝对数、C反应蛋白、IL-8、肿瘤坏死因子α、尿素之间具有显著差异（P<0.05）。结论：OMSI合并糖尿病、应激性高血糖、血糖正常患者的临床特征和实验室检查结果具有差异,提示临床诊疗时应当区分这3组患者,提供更具针对性的治疗措施。

关键词: 口腔颌面部, 间隙感染, 糖尿病, 应激性高血糖

Abstract: PURPOSE: To analyze the difference between oral and maxillofacial space infection(OMSI) patients with diabetes mellitus, stress hyperglycemia and normal blood glucose in general data, clinical manifestations, laboratory test, and dominant bacterial flora of infection. METHODS: A retrospective study was conducted in 190 patients diagnosed with oral and maxillofacial infection and treated at the Department of Oral Surgery, Shanghai Ninth People's Hospital from August 2020 to June 2022. Statistical analysis of general data, clinical manifestations, laboratory test, and dominant bacterial flora of infection between the three groups was performed with SPSS 25.0 software package. RESULTS: Between diabetic group and stress hyperglycemia group, absolute number of lymphocytes, sodium and chlorine differed significantly; between diabetic group and normal blood glucose group, age, neutrophil absolute number, neutrophil percentage, lymphocyte percentage, C-reactive protein, IL-6, IL-8, tumor necrosis factor-α, procalcitonin, urea, serum uric acid, fibrinogen, sodium, chlorine and total carbon dioxide differed significantly; between stress hyperglycemia group and normal glycemia group,the percentage of neutrophil, percentage of lymphocyte, absolute number of lymphocyte, C-reactive protein, IL-8, tumor necrosis factor-α, and urea differed significantly. CONCLUSIONS: The clinical features and laboratory results of OMSI patients with diabetes, stress hyperglycemia and normal blood glucose are significantly different, suggesting that the three groups of patients should be distinguished in clinical diagnosis and treatment, and more targeted treatment should be provided.

Key words: Oral and maxillofacial region, Space infection, Diabetes mellitus, Stress hyperglycemia

中图分类号:

R739.8

杨佐谊, 叶蕾, 郑凌艳, 陈昌钰, 傅稼耀. 190例口腔颌面部间隙感染合并高血糖患者回顾分析[J]. 中国口腔颌面外科杂志, 2023, 21(4): 360-365.

YANG Zuo-yi, YE Lei, ZHENG Ling-yan, CHEN Chang-yu, FU Jia-yao. Retrospective analysis of 190 cases of oral and maxillofacial space infection complicated with hyperglycemia[J]. China J Oral Maxillofac Surg, 2023, 21(4): 360-365.

参考文献

[1] Gams K, Freeman P.Temporomandibular joint septic arthritis and mandibular osteomyelitis arising from an odontogenic infection: a case report and review of the literature[J]. J Oral Maxillofac Surg, 2016, 74(4): 754-763.
[2] Han X, An J, Zhang Y, et al.Risk factors for life-threatening complications of maxillofacial space infection[J]. J Craniofac Surg, 2016, 27(2): 385-390.
[3] Yamaguchi R, Sakurada K, Saitoh H, et al.Fatal airway obstruction due to Ludwig’s angina from severe odontogenic infection during antipsychotic medication: a case report and a literature review[J]. J Forensic Sci, 2021, 66(5): 1980-1985.
[4] Bali R, Sharma P, Gaba S, et al.A review of complications of odontogenic infections[J]. Natl J Maxillofac Surg, 2015, 6(2): 136-143.
[5] Greenstein A, Witherspoon R, Leinkram D, et al.An unusual case of a brain abscess arising from an odontogenic infection[J]. Aust Dent J, 2015, 60(4): 532-535.
[6] Holmberg P, Hellmich T, Homme J.Pediatric sepsis secondary to an occult dental abscess: a case report[J]. J Emerg Med, 2017, 52(5): 744-748.
[7] Caranfa JT, Yoon MK.Septic cavernous sinus thrombosis: a review[J]. Surv Ophthalmol, 2021, 66(6): 1021-1030.
[8] 中华医学会糖尿病学分会.中国 2 型糖尿病防治指南(2020 年版)(上)[J].中国实用内科杂志, 2021, 41(8): 482-548.
Diabetics Branch of Chinese Medical Association. Guideline for the prevention and treatment of type 2 diabetes mellitus in China(2020 edition)(Part 1)[J]. Chinese Journal of Practical Internal Medicine, 2021, 41(8): 482-548.
[9] McCowen KC, Malhotra A, Bistrian BR, et al. Stress-induced hyperglycemia[J].Critic Care Clin, 2001, 17(1): 107-124.
[10] Vanhorebeek I, Gunst J, Van den Berghe G. Critical care management of stress-induced hyperglycemia[J]. Curr Diab Rep, 2018,18(4): 17.
[11] Marik PE, Bellomo R.Stress hyperglycemia: an essential survival response![J]. Crit Care Med, 2013, 41(6): e93-e94.
[12] Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control[J]. Diabetes Care, 2009, 32(6): 1119-1131.
[13] 周昊, 杨忠昕, 夏鑫, 等. 颌面部间隙感染并存糖尿病患者的临床特征分析[J].成都医学院学报, 2018, 13(2): 162-165.
Zhou H, Yang ZX, Xia X, et al.Analysis of clinical characteristics of patients with maxillofacial space infection and diabetes mellitus[J]. Journal of Chengdu Medical College, 2018, 13(2): 162-165.
[14] 张莉, 陈涌, 张亮. 口腔颌面部间隙感染糖尿病与非糖尿病的临床诊治对比[J].昆明医科大学学报, 2016, 37(12): 94-98.
Zhang L, Chen Y, Zhang L.Comparison of space infections in oral maxillofacial region between patients with and without diabetes[J]. Journal of Kunming Medical University, 2016,37(12): 94-98.
[15] 王冕,丁婕, 董晶, 等. 糖尿病对颌面部间隙感染患者治疗的影响[J]. 医学信息, 2016, 29(12): 86-87.
Wang M, Ding J, Dong J, et al.Effect of diabetes on the treatment of maxillofacial space infection[J]. Medical Information, 2016, 29(12): 86-87.
[16] Zhang C, Tang Y, Zheng M, et al.Maxillofacial space infection experience in West China: a retrospective study of 212 cases[J]. Int J Infect Dis, 2010, 14(5): e414-e417.
[17] Treviño-Gonzalez JL, Maldonado-Chapa F, González-Larios A, et al.Deep neck infections: demographic and clinical factors associated with poor outcomes[J]. ORL J Otorhinolaryngol Relat Spec, 2022, 84(2): 130-138.
[18] Lee MH, Carmichael RA, Read-Fuller AM, et al.Fatal deep neck infection and respiratory arrest[J]. Proc (Bayl Univ Med Cent), 2019, 32(1): 67-69.
[19] Velhonoja J, Lääveri M, Soukka T, et al.Early surgical intervention enhances recovery of severe pediatric deep neck infection patients[J]. Int J Pediatr Otorhinolaryngol, 2021, 144: 110694.
[20] Li Y, Min L, Zhang X.Usefulness of procalcitonin(PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children[J]. BMC Pulm Med, 2021, 21(1): 386-383.
[21] Sproston NR, Ashworth JJ.Role of C-reactive protein at sites of inflammation and infection[J]. Front Immunol, 2018, 9: 754.
[22] Hu L, Shi Q, Shi M, et al.Diagnostic value of PCT and CRP for detecting serious bacterial infections in patients with fever of unknown origin: a systematic review and meta-analysis[J]. Appl Immunohistochem Mol Morphol, 2017, 25(8): e61-e69.
[23] Lucas G, Bartolf A, Kroll N, et al.Procalcitonin(PCT) level in the emergency department identifies a high-risk cohort for all patients treated for possible sepsis[J]. EJIFCC, 2021,32(1): 20-26.
[24] Yang Q, Ghose P, Ismail N.Neutrophils mediate immunopathology and negatively regulate protective immune responses during fatal bacterial infection-induced toxic shock[J]. Infect Immun, 2013,81(5): 1751-1763.
[25] Vrachnis N, Zygouris D, Iliodromiti Z, et al.Probing the impact of sex steroids and menopause-related sex steroid deprivation on modulation of immune senescence[J]. Maturitas, 2014, 78(3): 174-178.

190例口腔颌面部间隙感染合并高血糖患者回顾分析

Retrospective analysis of 190 cases of oral and maxillofacial space infection complicated with hyperglycemia

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