| 荣明明,颜学兵.血小板 /淋巴细胞比值与细菌性肝脓肿病原学及预后相关性研究[J].安徽医药,2025,29(3):555-560. |
| 血小板 /淋巴细胞比值与细菌性肝脓肿病原学及预后相关性研究 |
| Correlation of platelet-lymphocyte ratio with the etiology and prognosis of bacterial liver abscess |
| |
| DOI：10.3969/j.issn.1009-6469.2025.03.024 |
| 中文关键词: 细菌性肝脓肿 肺炎克雷伯菌 大肠埃希菌 血小板 淋巴细胞 |
| 英文关键词: Bacterial liver abscess Klebsiella pneumoniae Escherichia coli Platelets Lymphocyte |
| 基金项目: |
|
| 摘要点击次数: 399 |
| 全文下载次数: 212 |
| 中文摘要: |
| 目的探讨细菌性肝脓肿( BLA)病人中血小板 /淋巴细胞比值( PLR)在判断病原学特征及预后情况的临床价值。方法选取 2016年 1月至 2021年 12月于徐州医科大学附属医院住院治疗且符合细菌性肝脓肿诊断标准的 BLA病人作为研究对象。分析该院 BLA病人的临床特征，筛选培养阳性率最高的两种病原菌:肺炎克雷伯菌肝脓肿(KPLA)与大肠埃希菌肝脓肿(ECLA)，比较 KPLA与非 KPLA组， ECLA与非 ECLA组临床特征；根据病人预后分为好转组及非好转组，通过多因素 logistic回归分析及受试者操作特征曲线(ROC曲线)探究 PLR在 BLA预后评估的预测价值。结果符合纳入标准的病人共 660例，以男(70.30%)为主，年龄( 58.23±13.75)岁，最常见的合并症为合并糖尿病(45.91%)；首位病原菌为肺炎克雷伯菌( 61.00％)，其次为性大肠埃希菌( 18.67%)。与非 KPLA组比较， KPLA组 PLR高( 210.95±200.45比 157.75±131.59)血小板低［(203.50±142.68)× 109/L比( 237.64±133.44)］ ×109/L，病人合并糖尿病多见( 59.90%比 41.90%)，白细胞计数高［(12，.67±5.04)×109/L比( 11.22±5.85)×109/L］(均 P<0.05)。 ECLA组合并胆道疾病、腹部手术史、脓肿多发比例较非 ECLA组高(均 P<0.05)，淋巴细胞计数［(1.24±0.62)×109/L比( 1.50±0.84)×109/L、血红蛋白( 108.51±23.82)g/L比( 117.56±19.72)g/L］较非 ECLA组低(均 P<0.05)。 BLA病人的预后不良影响因素包括:低水平 PLR、高水平白细胞计数、低水平血小板、合并胆道疾病。 ROC曲线分析显示， PLR曲线下面积( 0.61)最大，与 CRP差异有统计学意义，对 PLA预后不良的预测价值更大。结论 BLA致病菌首位为肺炎克雷伯菌，其次为大肠埃希菌。 KPLA病人中 PLR高、血小板减少更常见，低水平 PLR是 BLA预后不良影响因素。 |
| 英文摘要: |
| Objective To explore the clinical significance of the platelet-lymphocyte ratio (PLR) in the identification of etiological characteristics and prognosis in patients with bacterial liver abscess (BLA).Methods Patients meeting the diagnostic criteria for bac-terial liver abscess who were hospitalized in The Affiliated Hospital of Xuzhou Medical University from January 2016 to December2021 were selected as study objects. Clinical characteristics of the patients were analyzed and two clinical pathogens with the highestpositive rates, Klebsiella pneumoniae liver abscess (KPLA) and Escherichia coli liver abscess (ECLA), were screened and cultured. These patients were categorized into KPLA group and non-KPLA group, ECLA and non-ECLA group, to compare their clinical charac-teristics. According to the prognosis of the patients, they were assigned into improvement group and non-improvement group, and thepredictive value of PLR in the prognosis evaluation of BLA was explored by multivariate Logistic regression analysis and receiver oper-ating characteristic curve (ROC curve) .Results A total of 660 patients met the inclusion criteria, who were mainly males (70.30%),with an average age of (58.23±13.75) years, and the most common comorbidity was diabetes mellitus (45.91%). The most commonpathogen was Klebsiella pneumoniae (61.00%), followed by Escherichia coli (18.67%). Compared with the non-KPLA group, the KPLA group had higher PLR [(210.95±200.45) vs. (157.75±131.59)], lower platelet [(203.50±142.68) ×109/L vs. (237.64±133.44) ×109/L], more complicated diabetes mellitus (59.90% vs. 41.90%), and higher WBC [(12.67±5.04) ×109/L vs. (11.22±5.85) ×109/L] (all P<0.05). Compared with the non-ECLA group, the ECLA group had higher rates of biliary tract disease, history of abdominal surgery, and multi-ple abscesses (all P<0.05), lower lymphocyte count [(1.24±0.62) ×109/L vs. (1.50±0.84) ×109/L], and lower hemoglobin [(108.51±23.82) g/L vs. (117.56±19.72) g/L] (all P<0.05). Risk factors for poor prognosis in patients with BLA included low level of PLR, high WBC, lowPLT and concomitant biliary disease. ROC curve analysis results showed that the area under the PLR curve (0.61) was the largest, |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
