肺炎克雷伯菌肝脓肿患者发生侵袭综合征的危险因素分析  

Risk factors for invasive syndrome in patients with Klebsiella pneumoniae liver abscess

作　　者：赵鹏程 陈彦 董艳彬 Zhao Pengcheng;Chen Yan;Dong Yanbin(Department of Emergency and Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;The Affiliated Suzhou Hospital of Nanjing Medical University/Suzhou Municipal Hospital,Gusu School,Nanjing Medical University,Suzhou 215000,China)

机构地区：[1]南京医科大学第一附属医院急诊与危重症医学科,江苏南京210029 [2]南京医科大学附属苏州医院、苏州市立医院、南京医科大学姑苏学院,江苏苏州215000

出　　处：《中华卫生应急电子杂志》2024年第6期336-340,共5页Chinese Journal of Hygiene Rescue(Electronic Edition)

摘　　要：目的通过分析肺炎克雷伯菌肝脓肿患者的临床特征,探究患者发生侵袭综合征的危险因素。方法回顾性收集从2017年1月至2023年9月,在南京医科大学第一附属医院确诊为肺炎克雷伯菌肝脓肿的161例患者的资料,再依据住院期间是否出现侵袭综合征将161例患者分为侵袭组64例(39.8%)和非侵袭组97例(60.2%)。比较两组患者之间的基本资料、首诊症状、生命体征、实验室检查结果及影像学表现。使用单因素分析和多因素Logistic回归分析方法,评估各项指标与侵袭综合征发生的相关性。结果(1)病史方面:侵袭组患者的糖尿病患病率高于非侵袭组患者(P<0.05)。(2)症状体征方面:侵袭组患者的心率高于非侵袭组患者(P<0.05)。(3)影像学表现方面:侵袭组患者肝内脓肿的最大直径低于非侵袭组,而肝内脓肿为多发的概率高于非侵袭组(P<0.05)。(4)实验室检查方面:侵袭组与非侵袭组的各项实验室检查指标的差异均无统计学意义(P>0.05)。(5)经二元Logistic回归分析显示,独立危险因素包括:糖尿病患病史、心率较高、肝内脓肿最大直径较小(P<0.05)。结论肺炎克雷伯菌肝脓肿患者发生侵袭综合征的独立危险因素:糖尿病患病史、心率较高、肝内脓肿最大直径较小。临床上应加强对这些高风险患者的监测与早期干预,以降低侵袭综合征的危害。Objective To explore the risk factors for invasive syndrome in patients with Klebsiella pneumoniae liver abscess by analyzing the clinical characteristics of these patients.Methods A retrospective collection of data from 161 patients diagnosed with Klebsiella pneumoniae liver abscess at the First Affiliated Hospital of Nanjing Medical University between January 2017 and September 2023 was conducted.The 161 patients were divided into an invasive group of 64 cases(39.8%)and a non-invasive group of 97 cases(60.2%)based on whether invasive syndrome occurred during hospitalization.Basic data,initial symptoms,vital signs,laboratory examination results,and imaging manifestations were compared between the two groups.Univariate analysis and multivariate logistic regression analysis were used to assess the correlation of various indicators with the occurrence of invasive syndrome.Results The prevalence of diabetes in the invasive group was higher than that in the non-invasive group(P<0.05);The heart rate of patients in the invasive group was higher than that in the non-invasive group(P<0.05);Imaging manifestations showed that the maximum diameter of intra-hepatic abscesses in the invasive group was lower than that in the non-invasive group,while the probability of multiple intra-hepatic abscesses was higher in the invasive group than in the non-invasive group(P<0.05);There was no significant difference in the laboratory test indicators between the invasive group and the non-invasive group(P>0.05);Logistic regression analysis showed that independent risk factors included a history of diabetes,a higher heart rate,and a smaller maximum diameter of intra-hepatic abscesses(P<0.05).Conclusion Independent risk factors for invasive syndrome in patients with Klebsiella pneumoniae liver abscess include a history of diabetes,a higher heart rate,and a smaller maximum diameter of intra-hepatic abscesses.Clinically,it is necessary to strengthen the monitoring and early intervention for these high-risk patients to reduce the harm of inva

关 键 词：肝脓肿 糖尿病 肺炎克雷伯菌 侵袭综合征 脓毒症 危险因素 

分 类 号：R575[医药卫生—消化系统] R575.4[医药卫生—内科学]