肺炎克雷伯杆菌肝脓肿与非肺炎克雷伯杆菌肝脓肿的临床比较

目的:总结分析肺炎克雷伯杆菌肝脓肿与非肺炎克雷伯杆菌肝脓肿在临床方面的差异,为临床医生早诊断、早治疗提供依据．方法:总结2000-01／2005-01细菌性肝脓肿住院患者162例,利用统计学方法比较肺炎克雷伯杆菌与非肺炎克雷伯杆菌引起的肝脓肿在自然情况、伴发基础疾病、临床表现及实验室检查、肝脓肿特点、治疗方法及结果等方面的差异．结果:肺炎克雷伯杆菌肝脓肿112例(69．1％), 非肺炎克雷伯杆菌肝脓肿50例(30．9%),两组在年龄上存在统计学差异(P<0．05);两组患者在伴发糖尿病(66．1％vs 38．0％,P<0．01)、胆道疾患(14．3％vs 28．0％,P<0．05)、腹部创伤 (5．4％vs 16．0％,P<0．05)上存在统计学差异; 两组患者在贫血上存在统计学差异(60．7％vs 78％,P<0．05)．肺炎克雷伯杆菌肝脓肿多为单发脓肿,且多为单一病原体,两组间存在统计学差异(75．9％vs 58％,P<0．05;85．7％vs 64％, P<0．01)．两组间在迁徙性感染、死亡率上存在统计学差异(20．5％vs 6％,P<0．05;8．9％vs 26．0％,P<0．01)．结论:与非肺炎克雷伯杆菌肝脓肿组相比,肺炎克雷伯杆菌肝脓肿组发病年龄较低,伴发糖尿病的比例高,多为单发,单病原体,易形成迁徙性感染,死亡率较低．

Comparison between pyogenic liver abscess caused by Klebsiella pneumoniae and non- Klebsiella pneumoniae

AIM: To analyze the differences between pyogenic liver abscess caused by Klebsiella pneumonias (Kp) and non-Klebsiella pneumoniae (NKp), and provide the evidence for early diagnosis and treatment. METHODS: The clinical data of 162 patients with pyogenic liver abscess from January 2000 to January 2005 were collected, and statistical analysis was performed to compare the differences between the Kp and NKp patients in general characteristics, underlying diseases, clinical manifestations, laboratory features, and characteristics of liver abscess, treatments and outcomes. RESULTS: Of the 162 patients, 112 (69.1%) were classified into Kp group, and 50 (30.9%) were NKp group. There was significant difference between the two groups in ages (P < 0.05). For underlying diseases, there were significant differences in diabetes (66.1% vs 38.0%, P < 0.01), biliary diseases (14.3% vs 28.0%, P < 0.05) and abdominal injury (5.4% vs 16.0%, P < 0.05) between two groups. For clinical manifestations and laboratory features, there were also significant differences in anemia between two groups (60.7% vs 78%, P < 0.05). For characteristics of liver abscess, solitary liver abscess and monomicrobial isolates were more frequent in the Kp group than those in the NKp group (75.9% vs 58%, P < 0.05; 85.7% vs 64%, P < 0.01). For treatment and outcome, there were significant differences in metastatic infection and mortality rate between two groups (20.5% vs 6%, P < 0.05; 8.9% vs 26.0%, P < 0.01). CONCLUSION: In comparison with those in NKp patients, the age and mortality rate of Kp patients are lower, and the rate of diabetes and metastatic infection are higher. Monomicrobial isolates are mostly found in Kp patients.