ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA VIÊM PHỔI CỘNG ĐỒNG Ở BỆNH NHÂN ĐÁI THÁO ĐƯỜNG TÍP 2 ĐIỀU TRỊ TẠI BỆNH VIỆN TRUNG ƯƠNG THÁI NGUYÊN

Abstract

Objective: To describe the clinical and paraclinical characteristics of community-acquired pneumonia (CAP) in patients with type 2 diabetes mellitus treated at Thai Nguyen National Hospital. Subjects and Methods: A cross-sectional descriptive study was conducted on 117 inpatients diagnosed with CAP and with a history of type 2 diabetes mellitus, admitted from July 2024 to July 2025 at Thai Nguyen National Hospital. Results: The mean age of participants was 72.16 ± 12.30 years, with the highest proportion observed in those aged ≥ 80 years (57.2%). The male-to-female ratio was approximately 1:1.05. Common symptoms included fever (71.8%), dyspnea (53.8%), productive cough (65%), dry mouth with coated tongue (67.5%), and less frequent manifestations such as altered consciousness (11.1%), tachypnea (29.9%), and tachycardia (27.3%). Neutrophilia was present in 76.1% of cases. C-reactive protein (CRP) levels were mildly to moderately elevated in 83.8% of patients, while procalcitonin was markedly or severely elevated in 63.2%. Chest X-rays revealed diverse lesions, with multi-lobar involvement being common (right lung 21.4%, left lung 15.4%), often presenting as both consolidation and interstitial patterns. According to CURB-65, mild cases accounted for 46.2%, moderate 41.0%, and severe 12.8%. Notable biochemical predictors of severity included glucose >14 mmol/L (27.4%), urea >11 mmol/L (20.5%), hematocrit <30% (19.7%), and sodium <130 mmol/L (16.2%). Conclusion: The findings indicate that type 2 diabetic patients with CAP are typically elderly, often presenting with atypical clinical symptoms. However, paraclinical indicators such as elevated procalcitonin and CRP levels, multi-lobar involvement, and metabolic disturbances suggest severe disease progression. This underscores the need for early diagnosis, close monitoring of inflammatory markers, and strict glycemic control. Furthermore, vaccination, early recognition of respiratory symptoms, and individualized intensive treatment are essential to reduce complications and mortality.