不同血糖控制水平的化脓性肝脓肿患者临床特点和预后分析  

作　　者：张健[1] 沈振华 吴小昌[1] 

机构地区：[1]浙江省湖州市中心医院(湖州师范学院附属中心医院),313000

出　　处：《浙江临床医学》2022年第3期361-363,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省基础公益研究计划项目(LGF19H030003)。

摘　　要：目的分析不同血糖控制水平的化脓性肝脓肿患者的临床特点和预后因素。方法回顾性分析2014年1月至2019年12月116例化脓性肝脓肿合并糖尿病患者的临床资料。根据糖化血红蛋白(HbA1c)水平分为:A组(HbA1c≤7%)32例,B组(7%<HbA1c≤9%)46例、C组(HbA1c>9.0%)38例。分析三组患者的临床特征、并发症和预后因素。结果肝脓肿合并糖尿病患者中,C组平均住院时间明显长于A、B组;C组肝功能明显高于A、B组,C组白蛋白明显低于A、B组。C组寒战发热、乏力发生率明显高于A、B组,C组脓毒血症、肺部感染、急性肝衰、深静脉血栓的发生率明显高于A、B组。Logistic回归多因素分析提示体重指数、白蛋白和糖化血红蛋白水平是患者预后独立危险因素。结论肝脓肿伴糖尿病患者预后风险因素为体重指数、白蛋白和糖化血红蛋白,结合患者临床特点为临床诊治提供参考。Objective To analyze the clinical features and prognostic factors of pyogenic liver abscess with different levels of blood glucose.Methods 116 patients with pyogenic liver abscess combined with diabetes who were treated in our department from January 2014 to December 2019 were retrospectively analyzed.According to the glycated hemoglobin(HbA1C)levels:32 cases in group A with good blood glucose control(HbA1c≤7%),46 cases in group B with normal blood glucose control(7%<HbA1c≤9%),and 38 cases in group C with poor blood glucose control(HbA1c>9.0%).The clinical features,complications and prognostic factors of the three groups were analyzed.Results Among patients with liver abscess and diabetes mellitus,the average hospital stay of group C was significantly longer than that of group A and group B.The liver function of group C was significantly higher than that of group A and B,and the albumin was significantly lower than that of group A and B.The incidence of chills,fever and fatigue in group C was significandy higher than that in group A and B,and the incidence of sepsis,pulmonary infection,acute liver failure and deep vein thrombosis in group C was significandy higher than that in group A and B.Multivariate Logistic regression analysis indicated that body mass index,albumin and HbAlc levels were independent prognostic risk factors.Conclusion The prognostic risk factors of liver abscess with diabetes are body mass index N albumin and HbAlc.Combined with the clinical characteristics of the patients,it provides reference for clinical diagnosis and treatment.

关 键 词：肝脓肿 糖尿病 糖化血红蛋白 临床特点 并发症 预后因素 

分 类 号：R58[医药卫生—内分泌]