2型糖尿病并发细菌性肝脓肿患者的临床特征及治疗疗效评价

摘要/Abstract

摘要： 目的分析2型糖尿病(T2DM)并发细菌性肝脓肿(BLA)患者的临床特征及治疗疗效。方法收集2022年1月至 2024年12月收治的77例BLA患者临床资料,根据是否合并T2DM分为合并T2DM组、单纯BLA组,比较两组基线资料、临床表现或体征、血生化指标及临床转归。结果 77例BLA患者中合并T2DM 31例(合并T2DM组),其余为单纯BLA组(n=46)。合并T2DM组年龄、脓肿病程及呼吸道感染为(54.3±9.7)岁、(25.6±5.4)天及11例(35.4%),分别显著高于单纯BLA组[(47.8±9.0)岁、(17.8±4.4)天及4例(8.7%),P<0.05]。合并T2DM组贫血、腹痛、体重下降及脓毒血症等临床表现或体征为6例(19.3%)、20例(64.5%)、28例(90.3%)及21例(67.7%),分别显著重于单纯BLA组[1例(2.2%)、7例(15.2%)、25例(54.3%)及10例(21.7%),P<0.05]。经系统抗感染联合必要的脓肿穿刺置管引流,同时辅以血糖控制、合理膳食,合并T2DM组痊愈6例、好转19例、未愈5例、死亡1例,治疗有效率为83.9%,单纯BLA组痊愈9例、好转33例、未愈4例、死亡0例,治疗有效率为91.3%,差异无统计学意义(χ²=1.862,P=0.172)。结论 BLA合并T2DM患者临床表现更为复杂,病情更重,炎症反应更强,且伴有显著的代谢紊乱。然而,通过系统抗感染治疗、脓肿引流及综合干预措施,大多数患者仍可获得良好的治疗效果。

关键词: 细菌性肝脓肿, 2型糖尿病, 脓毒血症

Abstract: Objective To analyze the clinical features and therapeutic effects of type 2 diabetes mellitus (T2DM) complicated with bacterial liver abscess (BLA). Methods The clinical data of 77 patients with BLA between January 2022 and December 2024 were collected. Patients were divided into T2DM group and BLA group according to whether they were complicated with T2DM or not. The baseline data, clinical manifestations and signs, blood biochemical indexes and clinical outcomes of the two groups were compared. Results Among 77 cases of BLA, 31 cases were complicated with T2DM (T2DM group), and the other were simple BLA group (n=46). In T2DM group, the age, abscess course and respiratory infection were (54.3±9.7) years, (25.6±5.4) days and 11 cases (35.4%), which were significantly higher than those in BLA group [(47.8±9.0) years, (17.8±4.4) days and 4 cases (8.7%), P<0.05]. The clinical manifestations and signs of anemia, abdominal pain, weight loss and sepsis in T2DM group were significantly heavier than those in BLA group (P<0.05). The clinical manifestations or signs of anemia, abdominal pain, weight loss and sepsis in T2DM group were 6 cases (19.3%), 20 cases (64.5%), 28 cases (90.3%) and 21 cases (67.7%), which were significantly heavier than those in BLA group [1 case (2.2%), 7 cases (15.2%), 25 cases (54.3%) and 10 cases (21.7%), P<0.05]. After systemic anti-infection combined with necessary abscess puncture and drainage, supplemented by blood sugar control and reasonable diet, 6 cases were cured, 19 cases were improved, 5 cases were not cured and 1 case died in the group with T2DM, and the effective rate was 83.9%, while 9 cases were cured, 33 cases were improved, 4 cases were not cured and 0 cases died in the group with BLA alone, and the effective rate was 91.3%, with no statistical significance (χ²=1.862,P=0.172). Conclusion The clinical manifestations of BLA patients with T2DM are more complicated, and the condition is more serious. The inflammatory reaction is more intense, and the patients exhibits significant metabolic disorders. However, through systematic anti-infection treatment, abscess drainage and comprehensive intervention measures, most patients can still achieve a favorable therapeutic effect.

Key words: Bacterial liver abscess, Type 2 diabetes, Septicopyemia

许艳岚, 王晓薇. 2型糖尿病并发细菌性肝脓肿患者的临床特征及治疗疗效评价[J]. 肝脏, 2025, 30(5): 709-712.

XU Yan-lan, WANG Xiao-wei. Clinical characteristics and therapeutic effect evaluation of patients with type 2 diabetes complicated with bacterial liver abscess[J]. Chinese Hepatolgy, 2025, 30(5): 709-712.

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