2型糖尿病与非糖尿病合并细菌性肝脓肿患者实验室指标变化对诊断及疗效的预测价值  

Prediction value of laboratory index changes for diagnosis and curative effect in patients of bacterial liver abscess with or without type 2 diabetes mellitus

作　　者：夏杰 别玉坤[1] 杨成林[1] 冯以斌 张友满 王治伟[1] 徐初锋 XIA Jie;BIE Yu-kun;YANG Cheng-lin;FENG Yi-bin;ZHANG You-man;WANG Zhi-wei;XU Chu-feng(Department of General Surgery,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中心医院普通外科,陕西安康725000

出　　处：《海南医学》2022年第11期1391-1394,共4页Hainan Medical Journal

基　　金：陕西省安康市科学技术研究发展指导计划项目(编号:AK2020-SFZC-14)。

摘　　要：目的研究2型糖尿病与非糖尿病合并细菌性肝脓肿患者的临床表现与实验室指标变化对诊断及疗效的预测价值。方法采用回顾性研究方法,选取2015年1月至2021年1月期间安康市中心医院收治的121例细菌性肝脓肿患者为研究对象,其中合并2型糖尿病患者40例(合并组),未合并2型糖尿病患者81例(非合并组),比较两组患者的临床症状以及血小板计数(PLT)、白蛋白(ALB)、二氧化碳结合力(CO_(2)-CP)、白细胞(WBC)、中性粒细胞(NEUT)等实验室指标的差异,比较合并组不同疗效患者的实验室指标水平,采用操作特征曲线(ROC)分析实验室指标联合检测对合并2型糖尿病患者的疗效及诊断的预测价值。结果两组患者的畏寒寒颤、发热、乏力、呕吐、肝大以及黄疸比较差异均无统计学意义(P>0.05);合并组患者的腹痛、恶心、肝区叩痛和肝区压痛的发生率明显低于非合并组,差异均有统计学意义(P<0.05);合并组患者的PLT、ALB及CO_(2)-CP明显低于非合并组,WBC、NEUT明显高于非合并组,差异均有统计学意义(P<0.05);治疗有效组患者的PLT、ALB以及CO_(2)-CP明显高于无效组,WBC、NEUT明显低于无效组,差异均有统计学意义(P<0.05);通过ROC曲线分析结果显示,实验室指标联合检测对合并2型糖尿病患者疗效及诊断的曲线下面积显著高于单独检测,针对合并2型糖尿病诊断,WBC、PLT、ALB、CO_(2)-CP以及NEUT的临界值分别为13.42×10^(9)/L、172.99×10^(9)/L、23.09 g/L、18.26 mmol/L、86.44%,针对有效患者,WBC、PLT、ALB、CO_(2)-CP以及NEUT的临界值分别为13.69×10^(9)/L、185.22×10^(9)/L、25.29 g/L、20.69 mmol/L、80.54%。结论细菌性肝脓肿合并2型糖尿病患者可通过实验室联合检测进行诊断,并能预测其治疗效果。Objective To study the prediction value of laboratory index changes for diagnosis and curative effect in patients of bacterial liver abscess with or without type 2 diabetes mellitus.Methods In this study,a retrospective study was conducted in 121 patients with bacterial liver abscess admitted to Ankang Central Hospital from January 2015 to January 2021.The patients were divided into the combined group(40 patients with type 2 diabetes mellitus)and the non-combined group(81 patients without type 2 diabetes mellitus).The clinical symptoms and laboratory indexes,including blood platelet count(PLT),albumin(ALB),carbon dioxide combining power(CO_(2)-CP),white blood cell(WBC),and neutrophil ratio(NEUT)of two groups were compared.The differences of laboratory indicators between different treatment groups were compared.Receiver operating characteristic curve(ROC)curve method was used to analyze the clinical efficacy and diagnostic efficiency of combined laboratory test for patients with type 2 diabetes mellitus.Results There was no significant difference in chills,fever,fatigue,vomiting,hepatomegaly,and jaundice between the two groups(P>0.05).The abdominal pain,nausea,percussion pain in liver area,and tenderness in liver area in the combined group were significantly lower than those in the non-combined group(P<0.05).The PLT,ALB,and CO_(2)-CP in the combined group were significantly lower than those in the non-combined group,while WBC and NEUT in the combined group were significantly higher than those in the non-combined group,with statistically significant differences(P<0.05).PLT,ALB,and CO_(2)-CP in the effective group were significantly higher than those in the ineffective group,and WBC and NEUT were significantly lower than those in the ineffective group,with statistically significant differences(P<0.05).Through the ROC curve analysis,the area under the curve for combined test of laboratory indicators for the diagnosis of patients of bacterial liver abscess with type 2 diabetes mellitus is significantly higher than tha

关 键 词：细菌性肝脓肿 2型糖尿病 联合诊断 临床表现 实验室指标 

分 类 号：R587.1[医药卫生—内分泌]