摘要
目的:分析侵袭性肺炎克雷伯菌肝脓肿综合征(IKPLAS)的临床特征及相关危险因素.方法:回顾性分析2014 年8 月1 日至2023 年6 月31 日承德医学院附属医院收治的 442 例肺炎克雷伯菌肝脓肿患者临床资料,分为IKPLAS组431 例和非IKPLAS组11 例.比较两组临床特征,采用单因素及多因素Logistic回归分析肺炎克雷伯菌肝脓肿患者并发IKPLAS的危险因素.结果:单因素分析结果显示糖尿病、肝周脓肿、中性粒细胞比率、血红蛋白、含气脓肿及 SOFA 评分与 KPLA 患者并发 IKPLAS有关联.多因素Logistic回归分析得出入院时患有糖尿病[OR=8.922(95%CI:1.676～47.505)],中性粒细胞比率及血红蛋白是KPLA患者并发IKPLAS的独立影响因素,OR值分别为 0.947(95%CI:0.903～0.997)和0.970(95%CI:0.949～0.997).结论:患有糖尿病、中性粒细胞比率下降及血红蛋白下降是KPLA患者并发IKPLAS的独立危险因素.
Abstract
Objective:To analyze the clinical characteristics and risk factors associated with invasive Klebsiella pneumoniae liver abscess syndrome(IKPLAS).Methods:A retrospective analysis was conducted on the clinical data of 442 patients with Klebsiella pneumoniae liver abscess admitted to the Affiliated Hospital of Chengde Medical University from August 1,2014,to June 31,2023.The patients were divided into the IKPLAS group(431 cases)and the non-IKPLAS group(11 cases).Clinical features were compared between the two groups.Univariate and multivariate logistic regression analyses were used to identify risk factors for IK-PLAS in Klebsiella pneumoniae liver abscess patients.Results:Univariate analysis indicated that diabetes,perihepatic abscess,neutrophil ratio,hemoglobin level,gas-containing abscess,and SOFA score were associ-ated with the development of IKPLAS in patients with Klebsiella pneumoniae liver abscess.Multivariate logis-tic regression analysis identified diabetes at admission[OR=8.922(95%CI:1.676～47.505)],neutrophil ratio,and hemoglobin level as independent risk factors for IKPLAS,with OR values of 0.947(95%CI:0.903～0.997)and 0.970(95%CI:0.949～0.997),respectively.Conclusion:Diabetes,decreased neutrophil ratio,and reduced hemoglobin are independent risk factors for the development of IKPLAS in patients with Klebsiella pneumoniae liver abscess.
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