INCREASED INFECTION-RATE IN DIABETIC DIALYSIS PATIENTS EXPOSED TO COCAINE
INCREASED INFECTION-RATE IN DIABETIC DIALYSIS PATIENTS EXPOSED TO COCAINE
复制标题
DOI：
10.1016/s0272-6386(12)80094-1
复制
发表时间：
1991-09-01
影响因子：
13.2
通讯作者：
KALDANY, A
中科院分区：
文献类型：
--
作者：
DELIA, JA;WEINRAUCH, LA;KALDANY, A
护理人员对397名胰岛素依赖型糖尿病透析患者进行了寻求止痛剂行为的筛查。确定了38名患者，并将其分类为处方药滥用者（n = 26）或非法药物使用者（n =12）。与方案匹配的14名接受透析的胰岛素依赖型糖尿病患者相比，这9名可卡因使用者的糖尿病视网膜病变和代谢性神经病变相似。虽然没有统计学意义，但研究组的脑血管和心血管并发症更常见。消化道疾病合并营养不良的发生率高于对照组（P< 0.025）.可卡因组的感染率和严重程度明显更差：细菌性蜂窝织炎、脓毒症和脓肿各增加了4倍以上。所有的内脏感染都发生在可卡因使用组。可卡因使用者的肝炎病毒抗原和抗体增加了10倍。根据这些发现，制定了治疗有止痛剂寻求行为的透析患者的建议。
Three hundred ninety-seven insulin-dependent diabetic dialysis patients were screened by nursing staff for analgesic-seeking behavior. Thirty-eight patients were identified and classified as prescription abusers (n = 26) or illicit drug users (n =12). The nine cocaine users, when compared with 14 insulin-dependent diabetics on dialysis matched by protocol, were found to be similar in terms of diabetic retinopathy and metabolic neuropathy. Although statistically not significant, cerebrovascular and cardiovascular complications were more common in the study group. Gastroenteropathy with malnutrition was more common the study group (P< 0.025). Infection rate and severity were markedly worse in the cocaine group: bacterial cellulitis, sepsis, and abscess each increased greater than fourfold. All the visceral infections were in the cocaine-using group. Hepatitis viral antigen and antibody was increased 10-fold in the cocaine users. Recommendations for management of dialysis patients with analgesic-seeking behavior are formulated in light of these findings.