Department of Respiratory, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Health Management Center, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Clinics (Sao Paulo). 2019 Apr 8;74:e700. doi: 10.6061/clinics/2019/e700.
This study was conducted to investigate the risk factors for pulmonary abscess-related empyema by investigating the clinical characteristics and chest computed tomography imaging features of patients with pulmonary abscesses.
We retrospectively analyzed the chest computed tomography findings and clinical features of 101 cases of pulmonary abscess, including 25 cases with empyema (the experimental group) and 76 cases with no empyema (the control group). The potential risk factors for pulmonary abscess-related empyema were compared between the groups by using univariate and multivariate logistic regression analyses.
The incidence of pulmonary abscess-related empyema was 24.8% (25/101). Univariate analysis showed that male gender, diabetes, pleuritic symptoms, white blood cells >10×109/L, albumin level <25 g/L, and positive sputum cultures were potential clinical-related risk factors and that an abscess >5 cm in diameter and transpulmonary fissure abscesses were potential computed tomography imaging-related risk factors for pulmonary abscess-related empyema. Multivariate logistic regression analysis showed that transpulmonary fissure abscesses (odds ratio=9.102, p=0.003), diabetes (odds ratio=9.066, p=0.003), an abscess >5 cm in diameter (odds ratio=8.998, p=0.002), and pleuritic symptoms (odds ratio=5.395, p=0.015) were independent risk factors for pulmonary abscess-related empyema.
Transpulmonary fissure abscesses, diabetes, giant pulmonary abscesses, and pleuritic symptoms increased the risk of empyema among patients with pulmonary abscesses.
本研究旨在通过调查肺脓肿患者的临床特征和胸部计算机断层扫描（CT）影像学特征，探讨肺脓肿相关脓胸的危险因素。
我们回顾性分析了 101 例肺脓肿患者的胸部 CT 表现和临床特征，其中 25 例合并脓胸（实验组），76 例无脓胸（对照组）。采用单因素和多因素 logistic 回归分析比较两组患者发生肺脓肿相关脓胸的潜在危险因素。
肺脓肿相关脓胸的发生率为 24.8%（25/101）。单因素分析显示，男性、糖尿病、胸膜炎症状、白细胞计数＞10×109/L、白蛋白水平＜25 g/L、痰培养阳性是潜在的临床相关危险因素，脓肿直径＞5 cm 和跨肺裂脓肿是潜在的 CT 影像学相关危险因素。多因素 logistic 回归分析显示，跨肺裂脓肿（比值比=9.102，p=0.003）、糖尿病（比值比=9.066，p=0.003）、脓肿直径＞5 cm（比值比=8.998，p=0.002）和胸膜炎症状（比值比=5.395，p=0.015）是肺脓肿相关脓胸的独立危险因素。
跨肺裂脓肿、糖尿病、巨大肺脓肿和胸膜炎症状增加了肺脓肿患者发生脓胸的风险。
