关键词: 细菌性肝脓肿, 2型糖尿病, 病原菌, 炎症因子, 临床特征

Abstract: Objective The aim of this study was to summarize the clinical feature of patients with bacterial liver abscess (BLA) and concurrent underlying type 2 diabetes mellitus(T2DM). Methods 102 consecutive patients with BLA, of which, with concurrent underlying T2DM in 41 cases, were encountered in our hospital between May 2021 and October 2023, and all received antibiotics and intra-purulent cavity catheterization and pus drainage. Blood and/or pus bacterial culture and identification were conducted. Serum interleukin-6 (IL-6),C-reactive protein (CRP), procalcitonin (PCT), amyloid A (SAA) and D-dimer (D-D) levels were detected. Results Concurrent blood hypertension and pulmonary infections in patients with BLA and T2DM were 51.2% and 36.6%, both significantly higher than 18.0% and 8.2% (P<0.05) in those with BLA without T2DM; serum IL-6, CRP, PCT and SAA levels in patients with BLA and T2DM were 344.3(155.0, 511.9)pg/ml, 180.9(82.1, 270.7)mg/L, 8.6(5.7, 10.6)μg/L and 19.3(14.2, 25.5)mg/L, all significantly higher than [195.5(136.6, 274.1)pg/ml,124.8(52.5,190.4)mg/L, 2.2(1.4, 2.7)μg/L and 14.5(12.6, 20.1)mg/L, respectively, P＜0.05] in those with BLA; Klebsiella Pneumoniae infection rate in patients with BLA and T2DM was 78.0%, much higher than 57.4%(P＜0.05) in patients with BLA; catheterization for pus drainage and antibiotics therapy in patients with BLA and T2DM lasted for 6(3,10)d and 13(5, 20)d, both much longer than [4(2, 8)d and 10(4, 16)d,P＜0.05] in patients with BLA; all but one patient (2.4%) with BLA and T2DM who died recovered. Conclusion Pulmonary and Klebsiella pneumoniae infection is more common in patients with BLA and concurrent underlying T2DM, and antibiotics and intra-purulent cavity catheterization for pus drainage is efficacious with a satisfactory outcomes.

Key words: Bacterial liver abscess, Type 2 diabetes mellitus, Pathogenic bacteria, Inflammatory factors, Clinical feature