2型糖尿病与非2型糖尿病患者发生细菌性肝脓肿临床特征分析*

doi:10.3969/j.issn.1672-5069.2023.05.032

摘要/Abstract

摘要： 目的分析2型糖尿病(T2DM)与非2型糖尿病患者发生细菌性肝脓肿(PLA)的临床特征差异。方法 2016年1月～2021年12月我院收治的T2DM合并PLA患者54例,未合并T2DM的PLA患者72例,采用单用抗生素、脓肿穿刺抽脓联合抗生素或经皮肝脓肿穿刺置管引流联合抗生素治疗,观察临床特征的差异。结果合并T2DM组年龄为(58.6±8.4)岁,显著大于非T2DM组【(54.2±9.7)岁,P<0.05】,病程为(27.5±8.1)d,显著长于非T2DM组【(17.1±4.9),P<0.05】,合并心血管疾病的比率为24.1%,显著高于非T2DM组的9.7%(P<0.05);合并T2DM组腹痛、腹胀、黄疸和体质量下降发生率分别为63.0%、64.8%、25.9%和92.6%,显著高于非T2DM组(分别为19.4%、11.1%、12.5%和62.5%,P<0.05);入院时,T2DM组外周血WBC、NEUT和血清白蛋白水平分别为(17.8±5.2)×10⁹/L、(74.6±7.5)%和(28.4±4.8)g/L,显著低于非T2DM组【分别为(22.2±4.6)×10⁹/L、(85.2±9.3)%和(35.6±6.3)g/L,P<0.05】,而血清总胆红素水平为(30.8±4.8)μmol/L,显著高于非T2DM组【(16.5±3.4)μmol/L,P<0.05】;T2DM组单纯接受抗生素治疗的比率为22.2%,显著低于非T2DM组的38.9%,而接受抗生素联合脓肿置管引流的比率为48.1%,显著高于非T2DM组的33.3%,差异具有统计学意义(P<0.05);在治疗1个月末,T2DM组治愈率为74.1%,转为慢性脓肿比率为24.1%,而非T2DM组分别为87.5%和12.5%,两组差异具体统计学意义(P<0.05)。结论合并T2DM的PLA患者临床表现重,治疗大多需要置管引流,预后稍差,需要临床认真对待,以改善预后。

关键词: 细菌性肝脓肿, 2型糖尿病, 临床特征, 转归

Abstract: Objective The aim of this study was to analyze the clinical features of pyogenic liver abscess (PLA)in patients with underlying type 2 diabetes mellitus(T2DM). Methods 54 patients with PLA with underlying T2DM and 72 patients with PLA without T2DM were encountered in our hospital between January 2016 and December 2021, and dealt with antibiotics, puncture aspiration and catheter drainage alone or combination for one month. Results The age of patients with T2DM was (58.6±8.4)yr, significantly greater than [(54.2±9.7)yr, P<0.05], the disease period was (27.5±8.1)d, significantly longer than [(17.1±4.9), P<0.05], and the coincidence of cardiovascular diseases was 24.1%, significantly higher than 9.7%(P<0.05) in patients without T2DM; the incidences of abdominal pain, distension, jaundice and weight loss in patients with T2DM were 63.0%, 64.8%, 25.9% and 92.6%, all significantly higher than 19.4%, 11.1%, 12.5% and 62.5% (P<0.05) in patients without T2DM; at presentation, the white blood cell counts, the percentage of neutrophil cells and serum albumin level in patients with T2DM were (17.8±5.2)×10⁹/L,(74.6±7.5)% and (28.4±4.8)g/L, all significantly lower than[(22.2±4.6)×10⁹/L, (85.2±9.3)% and (35.6±6.3)g/L, respectively, P<0.05], while serum bilirubin level was (30.8±4.8)μmol/L, much higher than [(16.5±3.4)μmol/L, P<0.05] in patients without T2DM; the percentage of antibiotic therapy alone in patients with T2DM was 22.2%, much lower than 38.9%, while that of catheter drainage and antibiotic combination therapy was 48.1%, much higher than 33.3% (P<0.05) in patients without T2DM; at the end of one-month treatment, the recovery rate and becoming chronic abscess in patients with T2DM were 74.1% and 24.1%, significantly different compared to 87.5% and 12.5% in patients without T2DM (P<0.05). Conclusion The patients with PLA with underlying T2DM have a relatively severe clinical symptoms and poor prognosis, which might be carefully paid attention to and deal with appropriately.

Key words: Pyogenic liver abscess, Type 2 diabetes mellitus, Clinical feature, Outcomes

宁月季, 成家飞, 钱佶, 朱瑞农. 2型糖尿病与非2型糖尿病患者发生细菌性肝脓肿临床特征分析^*[J]. 实用肝脏病杂志, 2023, 26(5): 730-733.

Ning Yueji, Cheng Jifei, Qian Ji, et al. Clinical features of pyogenic liver abscess in patients with underlying type 2 diabetes mellitus[J]. Journal of Practical Hepatology, 2023, 26(5): 730-733.

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2型糖尿病与非2型糖尿病患者发生细菌性肝脓肿临床特征分析^*

Clinical features of pyogenic liver abscess in patients with underlying type 2 diabetes mellitus

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