中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 35 Issue 11
Nov.  2019
Turn off MathJax
Article Contents

Clinical features of diabetic patients with bacterial liver abscess and different levels of glycosylated hemoglobin

DOI: 10.3969/j.issn.1001-5256.2019.11.029
  • Received Date: 2019-06-11
  • Published Date: 2019-11-20
  • Objective To investigate the clinical features of diabetic patients with bacterial liver abscess and different levels of glycosylated hemoglobin( Hb Alc). Methods A total of 118 adult diabetic patients with bacterial liver abscess who were admitted to our hospital from December 2014 to December 2018 were enrolled,and according to the level of Hb Alc,they were divided into well-controlled group with 32 patients,fairly-controlled group with 31 patients,and poorly-controlled group with 55 patients. The three groups were compared in terms of general data,clinical manifestations,laboratory results,complications,and pathogen test results. A one-way analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results There were significant differences in mean age and length of hospital stay between the three groups( F = 2. 933 and 3. 310,both P < 0. 05). Compared with the other two groups,the poorly-controlled group had a significantly younger mean age of onset( P = 0. 016) and a significantly longer length of hospital stay( P = 0. 044). Hypertension was the most common underlying disease in diabetic patients with liver abscess,followed by biliary tract diseases and cerebral infarction,and there was a significant difference in cerebral infarction between the three groups( χ2= 6. 135,P =0. 037). Compared with the well-controlled group,the poorly-controlled group had significantly fewer and less typical signs of abdominal tenderness( χ2= 6. 178,P = 0. 046),and compared with the other two groups,the poorly-controlled group tended to have a significant increase in C-reactive protein( χ2= 5. 985,P = 0. 049) and were more likely to develop sepsis( χ2= 6. 247,P = 0. 044). Conclusion For diabetic patients with bacterial liver abscess,the patients with a poorly controlled Hb Alc level often have a young age of onset,a long length of hospital stay,and atypical clinical signs and are likely to develop sepsis,which may lead to insufficient attention in clinical practice,delay diagnosis and treatment,and even endanger life,and therefore,such patients should be taken seriously in clinical practice.

     

  • loading
  • [1] AKHONDI H,SABIH DE. Liver abscess[M]. Treasure Island(FL):Stat Pearls Publishing Stat Pearls Publishing LLC,2019.
    [2] LI W,CHEN H,WU S,et al. A comparison of pyogenic liver abscess in patients with or without diabetes:A retrospective study of246 cases[J]. BMC Gastroenterol,2018,18(1):144.
    [3] WANG HH. The association of haemoglobin A(1)C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus[J]. Eur Radiol,2014,24(5):980-989.
    [4] WHO. New diagnostic criteria and typing system for diabetes[J]. Chin J Diabetes,2000,8(1):5-6.(in Chinese)WHO.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.
    [5] CHEN J. Cryptogenic and non-cryptogenic liver abscess:A retrospective analysis of 178 cases revealed distinct characteristics[J]. Int Med Res,2018,46(9):3824-3836.
    [6] KUBOVY J,KARIM S,DING S,et al. Pyogenic liver abscess:Incidence,causality,management and clinical outcomes in a New Zealand cohort[J]. N Z Med J,2019,132(1492):30-35.
    [7] WANG WJ,TAO Z,WU HL,et al. Etiology and clinical manifestations of bacterial liver abscess:A study of 102 cases[J]. Medicine(Baltimore),2018,97(38):e12326.
    [8] MCEWAN P,FOOS V,LAMOTTE M,et al. The impact of baseline Hba1c and Hba1c trajectories on time to therapy escalation in type 2 diabetes mellitus[J]. Value Health,2015,18(7):a698.
    [9] WALRAVEN L. Distinct HbA1c trajectories in a type 2 diabetes cohort[J]. Acta Diabetol,2015,52(2):267-275.
    [10] Chinese Society of Diabetes,Chinese Medical Association.Guidelines for the prevention and treatment of type 2 diabetes in China(version 2017)[J]. Chin J Diabetes,2018,10(1):4-67.(in Chinese)中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
    [11] QIU YP,ZHANG YC,XU YH. Study on the influence of changes in blood levels of HbAlc on hypertension and coronary heart disease in patients with diabetes mellitus[J]. J Clin Exp Med,2018,17(2):166-169.(in Chinese)邱永平,张运超,徐悦和.糖尿病患者糖化血红蛋白水平变化对高血压及冠心病的临床影响分析[J].临床和实验医学杂志,2018,17(2):166-169.
    [12] KO MC. A cohort study of age and sex specific risk of pyogenic liver abscess incidence in patients with type 2 diabetes mellitus[J]. Medicine(Baltimore),2019,98(17):e15366.
    [13] LAI YR. HbA1C variability is strongly associated with the severity of peripheral neuropathy in patients with type 2 diabetes[J]. Front Neurosci,2019,13:90.
    [14] ZHANG J. Comparison of clinical characteristics and outcomes of pyogenic liver abscess patients <65 years of age versus>/=65 years of age[J]. BMC Infect Dis,2019,19(1):233.
    [15] LEE CR. Antimicrobial resistance of hypervirulent klebsiella pneumoniae:Epidemiology, hypervirulence-associated determinants,and resistance mechanisms[J]. Front Cell Infect Microbiol,2017,7:483.
    [16] SHANKAR C,VEERARAGHAVAN B. Whole genome analysis of hypervirulent Klebsiella pneumoniae isolates from community and hospital acquired bloodstream infection[J]. BMC Microbiol,2018,18(1):6.
    [17] JUN JB. Klebsiella pneumoniae liver abscess[J]. Infect Chemother,2018,50(3):210-218.
    [18] CHEN F,ZHANG YT,QIAO HJ,et al. Clinical features of Klebsiella pneumoniae liver abscess[J]. J Clin Hepatol,2016,32(4):764-768.(in Chinese)陈帆,张艳亭,乔慧捷,等.肺炎克雷伯菌肝脓肿的临床特征分析[J]临床肝胆病杂志,2016,32(4):764-768.
    [19] HUANG Y. Research advances in diagnosis and treatment of bacterial liver abscess[J]. J Clin Hepatol,2018,34(3):641-644.(in Chinese)黄洋.细菌性肝脓肿的诊治进展[J].临床肝胆病杂志,2018,34(3):641-644.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1115) PDF downloads(276) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return