Abstract Objective To analyze the clinical characteristics of pyogenic liver abscess (PLA) patients with diabetes mellitus in order to guide the clinical diagnosis and treatment. Methods A total of 225 patients with PLA treated in the First Affiliated Hospital of Chongqing Medical University from January 2015 to December 2019 were selected, they were divided into diabetic group (109 cases) and non-diabetic group (116 cases) according to whether they had diabetes or not. The general data, basic diseases, clinical manifestation, laboratory findings, pathogenic results, complications, treatment and prognosis of the two groups were analyzed retrospectively. Results The mean age of diabetic group was higher than that of non-diabetic group (P ＜ 0.05). The probability of hypertension and cerebral infarction in diabetic group was higher than that in non-diabetic group (P ＜ 0.05). The probability of fever and fatigue in diabetic group was higher than that in non-diabetic group (P ＜ 0.05), and the prealbumin level was lower than that in non-diabetic group (P ＜ 0.05). Abdominal distension, abdominal pain, vomiting, chills and abdominal tenderness, tap pain, white blood cell count, liver area percentage granulocyte, hemoglobin, platelet count, albumin, alanine aminotransferase, aspartate aminotransferase, total bilirubin, activated clotting time live enzymes, prothrombin time, blood urea nitrogen, serum creatinine, calcitonin original differences between groups were no statistical significance (all P ＞ 0.05). The infection rate of total negative bacteria and Klebsiella Pneumoniae (KP) in diabetic group was higher than that in non-diabetic group, and the infection rate of streptococcus mueller group was lower than that in non-diabetic group (P ＜ 0.05). The proportion of pneumonia, sepsis and septic shock in DM group was higher than that in non-diabetic group (P ＜ 0.05), and there was no significant difference in antibiotic use and prognosis between the two groups (P ＞ 0.05). Conclusion PLA complicated with diabetes is common in middle-aged and elderly men with atypical clinical manifestations, easy to be complicated with KP infection, and more prone to complications such as pneumonia, sepsis, septic shock.
XIAO Juan XIN Xiaojun▲. Analysis of clinical characteristics of pyogenic liver abscess patients with diabetes mellitus[J]. 中国医药导报, 2021, 18(14): 128-131.
[1] Wang WJ，Tao Z，Wu HL. Etiology and clinical manifestations of bacterial liver abscess：A study of 102 cases[J]. Medicine（Baltimore），2018，97（38）：e12326.
[2] Kaplan GG，Gregson DB，Laupland KB. Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess [J]. Clin Gastroenterol Hepatol，2004，2（11）：1032-1038.
[3] Tsai FC，Huang YT，Chang LY，et al. Pyogenic Liver Abscess as Endemic Disease，Taiwan[J]. Emerg Infect Dis，2008，14（10）：1592-1600.
[4] Meddings L，Myers RP，Hubbard J，et al. A population-based study of pyogenic liver abscesses in the United States：incidence，mortality，and temporal trends[J]. Am J Gastroenterol，2010，105（1）：117-124.
[5] Du Z，Zhou X，Zhao J，et al. Effect of diabetes mellitus on short-term prognosis of 227 pyogenic liver abscess patients after hospitalization[J]. BMC Infect Dis，2020，20（1）：145.
[6] 世界卫生组织.关于糖尿病的新诊断标准与分型[J].中国糖尿病杂志，2000，8（1）：5-6.
[7] Mücke MM，Kessel J，Mücke VT，et al. The role of Enterococcus spp. and multidrug-resistant bacteria causing pyogenic liver abscesses [J]. BMC Infect Dis，2017，17（1）：450.
[8] 尚红，王毓三，申子瑜.全国临床检验操作规程[M].4版.北京：人民卫生出版社，2015：2-296.
[9] 张慧，张照如，李家斌.细菌性肝脓肿合并糖尿病患者的临床特点[J].中华传染病杂志，2017，35（6）：364-368.
[10] Li W，Chen H，Wu S，et al. A comparison of pyogenic liver abscess in patients with or without diabetes：a retrospective study of 246 cases [J]. BMC Gastroenterol，2018， 18（1）：144.
[11] 黄洋，张伟辉.细菌性肝脓肿的诊治进展[J].临床肝胆病杂志，2018，34（3）：641-644.
[12] 范陈良，李小四，龚黎.2型糖尿病并发感染患者危险因素、病原学检测及其预后分析[J].中国卫生检验杂志，2019，29（23）：2925-2927.
[13] 翟群超，黄海泉，明慧，等.2型糖尿病合并血流感染的病原菌分布及耐药性研究[J].中国感染与化疗杂志，2020， 20（3）：294-300.
[14] 吴青青，潘宏仪，郑伟，等.细菌性肝脓肿合并和未合并糖尿病患者的临床特点及预后因素分析[J].国际流行病学传染病学杂志，2019，46（1）：55-60.
[15] 陈梦诗，林志辉.合并和未合并糖尿病的细菌性肝脓肿临床资料对比研究[J].创伤与急诊电子杂志，2020，8（2）：77-81.
[16] 陈薇，杨春凤，曹阳，等.肺炎克雷伯菌肝脓肿发病危险因素及致病菌耐药性分析[J].中华传染病杂志，2018， 36（10）：630-634.
[17] Kong H，Yu F，Zhang W，et al. Clinical and microbiological characteristics of pyogenic liver abscess in a tertiary hospital in East China [J]. Medicine （Baltimore），2017， 96（37）：e8050.
[18] 惠鹏，朱鹏，廖威，等.细菌性肝脓肿菌群分布与耐药性分析的多中心回顾性研究（附897例报告）[J].中华消化外科杂志，2019，18（10）：924-933.
[19] 周义，李昌平.252例细菌性肝脓肿临床病原学特点及耐药性分析[J].重庆医学，2018，47（11）：1551-1554.
[20] 邓国平，顾文超，刘锦铭.老年糖尿病患者合并肺部感染病原菌分布及耐药性研究[J].山西医药杂志，2020， 49（1）：45-47.
[21] 郭明凤，陈玲玲.细菌性肝脓肿致感染性休克的危险因素与护理[J].解放军护理杂志，2020，37（6）：71-73，77.
[22] 齐文旗，黄椿媚，边帆，等.肝脓肿致脓毒血症的危险因素及早期诊断[J].中华急诊医学杂志，2019，28（11）：1383-1389.
[23] Khim G，Em S，Mo S，et al. Liver abscess：diagnostic and management issues found in the low resource setting [J]. Br Med Bull，2019，132（1）：45-52.
[24] Mukthinuthalapati VVPK，Attar BM，Parra-Rodriguez L，et al. Risk Factors，Management，and Outcomes of Pyogenic Liver Abscess in a US Safety Net Hospital [J]. Dig Dis Sci，2020，65（5）：1529-1538.
[25] 李萌芳，刘国栋，赵光举，等.化脓性肝脓肿在糖尿病患者中的临床特点及预后因素分析[J].中华危重症医学杂志：电子版，2015（2）：96-99.
