【目的】 分析支气管扩张症（简称“支扩”）合并2型糖尿病（T2DM）的危险因素及其中医证型、病原体分布特征。【方法】 选取 2022年 6月至 2024年 6月因急性加重入住广州中医药大学附属广东中西医结合医院的支扩患者 299例，根据是否合并 T2DM分为支扩合并T2DM组74例和单纯支扩组225例。收集患者临床资料，采用单因素分析及多因素Logistic 回归模型分析 支扩合并T2DM的危险因素，并统计分析中医证型及病原体分布。【结果】（1）危险因素方面：单因素分析结果显示，2组患者 的性别、年龄、体质量指数（BMI）、高血压、冠状动脉粥样硬化心脏病（简称冠心病）、动脉粥样硬化、第1秒用力呼气容积 与用力肺活量的比值（FEV1/FVC）、白细胞计数（WBC）、中性粒细胞计数（NEUT）、C反应蛋白（CRP）、纤维蛋白原（FGB）比 较，差异均有统计学意义（P＜0.05或P＜0.01）；多因素Logistic回归分析结果显示，性别、BMI、高血压、FEV1/FVC为影响 支扩合并 T2DM的独立危险因素。（2）中医证型分布方面：2组患者均以痰热蕴肺证、痰湿阻肺证为主，其中支扩合并 T2DM 组的痰热壅肺证的比例更高。（3）病原体分布方面：支扩合并T2DM组的流感嗜血杆菌、鲍曼不动杆菌、肺炎克雷伯菌的占比 较高，单纯支扩组以铜绿假单胞菌为主；支扩合并T2DM组的病毒比例明显较高，主要以甲型流感病毒、鼻病毒、新型冠状 病毒为主；支扩合并T2DM组的真菌以白色念珠菌多见。【结论】 支气管扩张症合并T2DM的独立危险因素是性别、BMI、高 血压、FEV1/FVC，其中医证型以痰热壅肺证、痰湿阻肺证为主，病原体感染多见于革兰阴性菌、病毒、真菌感染。

Objective To analyze the risk factors，traditional Chinese medicine （TCM） syndromes，and pathogen distribution in patients with bronchiectasis （BE） complicated with type 2 diabetes mellitus （T2DM）. Methods From June 2022 to June 2024， a total of 299 patients with acute exacerbation of BE admitted to Guangdong Integrated Chinese and Western Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine were selected. Based on the presence of T2DM，the patients were divided into the BE-T2DM group （74 cases） and the BE-only group （225 cases）. Clinical data of the patients were collected，and univariate analysis and multivariate logistic regression models were used to identify risk factors for BE complicated with T2DM. TCM syndromes and pathogen distribution were statistically analyzed. Results （1）Univariate analysis showed that there were statistically significant differences between the two groups in gender，age，body mass index （BMI），hypertension，coronary atherosclerotic heart disease （shortened to coronary heart disease），atherosclerosis，the ratio of forced expiratory volume in one second to forced vital capacity （FEV1/FVC），white blood cell count （WBC），neutrophil count （NEUT），C-reactive protein（CRP），and fibrinogen（FGB）（P＜0.05 or P＜0.01）. Multivariate logistic regression analysis for the risk factors showed that gender，BMI，hypertension，and FEV1/FVC were the independent risk factors for BE complicated with T2DM.（2） In terms of the distribution of TCM syndromes， both groups were mainly characterized by phlegm-heat accumulating in the lung syndrome and phlegm-damp obstructing the lung syndrome， and BE-T2DM group had a higher proportion of phlegm-heat accumulating in the lung syndrome. （3）For the infection of pathogens， BE-T2DM group had a higher infection rate of Haemophilus influenzae， Acinetobacter baumannii，and Klebsiella pneumoniae，while the BE-only group was predominantly infected with Pseudomonas aeruginosa；BE-T2DM group had a significantly higher rate of viral infections，mainly infected with influenza A virus，rhinovirus，and SARS-CoV-2；BE-T2DM group also suffered from fungal infections，usually infected with Candida albicans. Conclusion For BE patients complicated with T2DM，the independent risk factors are gender，BMI，hypertension，and FEV1/FVC；the common TCM syndromes are phlegm-heat accumulating in the lung and phlegm-damp obstructing the lung； pathogen infections are mainly caused by Gram-negative bacteria，viruses，and fungi.

R259.622；R259.871

广东省中医药重点学科（临床类） 建设项目（编号：粤中医办函[2021]129 号）；广东省中医药局科研项目（编号：20211062）； 佛山市“十四五”中医重点专科项目（编号：粤卫函[2020]15号）