探究糖尿病对细菌性肝脓肿临床特征的影响

To Explore the Influence of Diabetes on the Clinical Features of Bacterial Liver Abscess

摘要: 目的：探讨糖尿病对细菌性肝脓肿(PLA)临床特征的影响。方法：回顾性分析青岛大学附属医院2013年1月至2023年1月青岛大学附属医院诊治的529例PLA患者的资料，根据是否合并糖尿病分为糖尿病组(n = 251)和非糖尿病组(n = 278)，分析各组之间的临床特征差异。结果：与非糖尿病组相比，糖尿病组患者合并高血压、冠心病的比例更高(p < 0.05)，患病平均年龄更大(p < 0.05)；而糖尿病组近3月内腹腔术后患者的比例明显低于非糖尿病组(p < 0.05)；与非糖尿病组相比，糖尿病患者更容易出现腹泻症状(p < 0.05)；与非糖尿病组相比，糖尿病组合并肺炎、出现多脏器器官功能衰竭及预后不佳的比例更高(p < 0.05)；与非糖尿病组相比，糖尿病组细菌培养为肺炎克雷伯菌比例更高(p < 0.05)，而非糖尿病组更容易培养出大肠埃希氏菌(p < 0.05)。与非糖尿病组相比，糖尿病组降钙素原更高，白细胞及中性粒细胞计数、血红蛋白水平、总胆红素、国际标准化比值、纤维蛋白原水平更低(p < 0.05)。结论：合并糖尿病的肝脓肿患者既往史多合并高血压、糖尿病，更容易出现多脏器器官功能衰竭甚至死亡等结局，其病原菌为肺炎克雷伯菌的可能性更大。

Abstract: Objective: To investigate the effect of diabetes mellituson clinical features of pyogenic liver abscess (PLA). Methods: The clinical data of 529 patients with PLA in the Affiliated Hospital of Qingdao University from January 2013 to January 2023 were retrospectively analyzed. According to the presence or absence of diabetes, patients were divided into diabetic group (n = 251) and non-diabetic group (n = 278). Results: Compared with non-diabetes group, diabetes group had higher proportion of hypertension and coronary heart disease (p < 0.05), and the average age of disease was older (p < 0.05). The proportion of patients undergoing abdominal surgery within 3 months in the diabetic group was significantly lower than that in the non-diabetic group (p < 0.05). Compared with the non-diabetic group, the diabetic group was more likely to have diarrhea (p < 0.05). Compared with the non-diabetic group, the diabetic group had a higher proportion of pneumonia, multiple organ failure and poor prognosis (p < 0.05). Compared with the non-diabetic group, the diabetic group had a higher proportion of Klebsiella pneumoniae (p < 0.05), while the non-diabetic group was more likely to culture Escherichia coli (p < 0.05). Compared with the non-diabetic group, the diabetic group had a significantly higher procalcitonin level and significantly lower white blood cell count, neutrophil count, hemoglobin level, total bilirubin, international normalized ratio, and fibrinogen level (p < 0.05). Conclusions: Patients with liver abscess complicated with diabetes are more likely to have hypertension, diabetes, multiple organ failure and even death, and the pathogen is more likely to be Klebsiella pneumoniae.