人类免疫缺陷病毒感染对肝脓肿预后的预测价值分析

肝脏 ›› 2021, Vol. 26 ›› Issue (9): 1019-1023.

人类免疫缺陷病毒感染对肝脓肿预后的预测价值分析

丁蕊, 王琦, 刘丽改, 赵文珊, 谢雯

100015 首都医科大学附属北京地坛医院肝病中心

收稿日期:2021-02-14 出版日期:2021-09-30 发布日期:2021-10-22
通讯作者: 谢雯,Email:xiewen6218@163.com
基金资助:
北京市医院管理局重点医学专业发展计划(ZYLX201808);北京市科委科技计划重大项目(D171100003117005);北京市医院管理中心消化内科学科协同发展中心消化专项重点项(XXZ0402)

Predictive value of human immunodeficiency virus infection on prognosis pyogenic of liver abscess

DING Rui, WANG Qi, LIU Li-gai, ZHAO Wen-shan, XIE Wen

Center of Liver Disease, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

Received:2021-02-14 Online:2021-09-30 Published:2021-10-22
Contact: XIE Wen, Email: xiewen 6218@163.com

摘要/Abstract

摘要： 目的探讨HIV感染对肝脓肿预后的预测价值。方法收集2016年1月至2019年12月首都医科大学附属北京地坛医院收治的肝脓肿患者139例,根据肝脓肿患者住院后30 d转归,分为好转组、非好转组,比较两组之间临床特点。并且根据患者是否合并HIV感染,分为HIV组、非HIV组,比较两组之间临床特点。利用Logistic回归筛选肝脓肿患者30 d内预后不良的独立危险因素。结果入组139例肝脓肿患者中,男性112例(80.6%),合并HIV阳性48例(34.5%),好转组108例(77.7%)。非好转组合并HIV患者比例高于好转组患者(P=0.023)。肝脓肿患者血培养阳性率为18.2%(22/121),脓液培养阳性率为24.7%(24/97),肺炎克雷伯菌分别占HIV组、非HIV组患者的12.5%(1/8)、92.1%(35/38),差异有统计学意义(P<0.01)。Logistic回归分析显示, 年龄增加 (OR=1.048, 95%CI: 1.010~1.087, P=0.012)、HIV感染 (OR=4.264,95%CI: 1.647~11.041, P=0.003)、脓肿多发(OR=3.157, 95%CI: 1.265~7.882, P=0.014)、总胆红素升高(OR=1.027, 95%CI: 1.003~1.051, P=0.025)是PLA患者预后不良的独立危险因素。结论合并HIV感染为肝脓肿患者短期预后不良的独立危险因素。

关键词: 人类免疫缺陷病毒, 肝脓肿, 不良预后

Abstract: Objective To analyze the clinical characteristics of pyogenic liver abscess (PLA) in patients infected with human immunodeficiency virus (HIV), and to evaluate the predictive value of HIV infection on the prognosis of PLA. Methods We performed a single-center retrospective study of 139 patients with PLA in Beijing Ditan Hospital, Capital Medical University from January 2016 to December 2019. Differences were compared among patients with /without HIV infection. Risk factors for poor prognosis of patients with PLA within 30 days were evaluated. Results Patients with HIV infection had a poor outcome than patients without HIV infection (P=0.023). The positive rates of bacteria culture were 18.2% (22/121) in blood and 24.7% (24/97) in pus. Klebsiella pneumoniae accounted for 12.5% (1/8) in HIV group and 92.1% (35/38) in non-HIV group, respectively (P<0.001). Logistic regression analysis showed that older age (OR=1.048, 95% CI: 1.010-1.087, P=0.012), HIV infection (OR=4.264, 95% CI: 1.647-11.041, P=0.003), multiple abscesses (OR=3.157,95% CI: 1.265-7.882, P=0.014), and increased total bilirubin (OR=1.027,95% CI: 1.003-1.051, P=0.025) were independent risk factors for poor prognosis in PLA patients. Conclusion It seems that HIV infection can predict the short-term prognosis of PLA in clinical practice.

Key words: Human immunodeficiency virus, pyogenic liver abscess, Poor prognosis

丁蕊, 王琦, 刘丽改, 赵文珊, 谢雯. 人类免疫缺陷病毒感染对肝脓肿预后的预测价值分析[J]. 肝脏, 2021, 26(9): 1019-1023.

DING Rui, WANG Qi, LIU Li-gai, ZHAO Wen-shan, XIE Wen. Predictive value of human immunodeficiency virus infection on prognosis pyogenic of liver abscess[J]. Chinese Hepatolgy, 2021, 26(9): 1019-1023.

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