糖尿病患者不同HbA1C控制水平肺炎克雷伯杆菌肝脓肿的临床和影像学表现  

The clinic and imaging features of Klebsiella pneumoniae liver abscess in diabetes mellitus patients with different levels of HbA1c

作　　者：蔡熹[1] 丁炎[1] 朱晨霞[1] 朱巧英[1] 吴鹏西[1] 周昊[1] 

机构地区：[1]南京医科大学附属无锡人民医院超声医学科,江苏无锡214023

出　　处：《西部医学》2016年第12期1744-1747,1751,共5页Medical Journal of West China

摘　　要：目的比较糖尿病(DM)患者不同血糖控制水平下肺炎克雷伯杆菌肝脓肿(KPLA)的临床和影像学表现。方法 146例糖尿病肺炎克雷伯杆菌肝脓肿(KPLA-DM)患者根据糖化血红蛋白浓度(HbA1C)分为控制好组(HbA1C≤7%)、控制较好组(7%<HbA1C≤9%)和控制差组(HbA1C>9%)3组。分别比较3组的一般情况、临床特点、影像学表现及并发症情况。结果与血糖控制好和良好的患者相比,血糖控制差的患者发病年龄低,住院时间更长,更易合并高脂血症、慢性肾功能不全等基础疾病,且并发症及需积极抢救的临床危象多见,转移性感染多发。影像学表现中,血糖控制差的病人胆管系统积气、肝静脉血栓性静脉炎、肝脓肿产气发生率增高。结论 KPLA-DM患者血糖控制差与肝静脉血栓性静脉炎、气体形成和转移性肝脓肿并发症有关。Objective To analyze the clinic and imaging features of Klebsiella pneumoniae liver abscess in diabetes mellitus patients with different levels of HbAlc. Methods One hundred and forty-six diabetes patients with KPLA were divided on the basis of their levels of HbAlc into three groups： complete glycemic controlled （HbAlc ≤7 %）; good glycemic controlled （7 % 〈 HbA1C≤9 % ） ; bad glycemic controlled （ HbA1C〉 9 % ）. Compared the patients＇ characteristics, clinic features, imaging features and complications among each group. Results Compared with patients in groups of complete and good glyeemic controlled, patients in group of bad glycemic controlled tend to have younger age at onset, longer hospital stay and more experience complications such as： hyperlipoidemia, chronic renal failure, life-threatening clinical crisis, and higher infection rate. Patients in bad glycemic controlled also had high risk of biliary pneumatosis, hepatic venous thrombosis and gas-forming pyogenic liver abscess. Conclusion The complications of hepatic venous thrombosis, gas-forming and infection in diabetes patients with KPLA are associated with glycemic uncontrolled.

关 键 词：糖尿病 糖化血红蛋白 肺炎克雷伯杆菌肝脓肿 

分 类 号：R445[医药卫生—影像医学与核医学] R657.33[医药卫生—诊断学]