Jha Ashish K, Jha Praveen, Chaudhary Madhur, Purkayastha Shubham, Jha Sanjeev K, Ranjan Ravish, Priyadarshi Rajeev N, Kumar Ramesh
Department of Gastroenterology Indira Gandhi Institute of Medical Sciences Patna India.
Department of Radiology All India Institute of Medical Sciences Patna India.
JGH Open. 2019 May 30;3(6):474-479. doi: 10.1002/jgh3.12183. eCollection 2019 Dec.
Although the mortality rate has declined in recent years, amoebic liver abscesses (ALAs) still carry a substantial risk of morbidity. Studies regarding the indicators of severity, complication, or prognosis of ALA are limited in number and heterogeneous in methodology and results.
Clinicodemographic profile, therapeutic modalities, and outcomes of indoor ALA patients admitted between January 2016 and October 2017 were analyzed. An analysis of possible prognostic factors associated with complications and interventional therapy in patients with ALA was performed retrospectively.
Data of 198 patients with ALA (mean age: 45 ± 12.1; M:F ratio: 193:5) were analyzed. The volume of abscess (503.1 ± 391.2: 300.2 ± 305.8 mL), elevated liver enzymes, and duration of hospital stay (11.98 ± 5.75): 10.23 ± 4.1 days) were significantly ( < 0.05) higher in alcoholic, compared to nonalcoholic, individuals. On univariate analysis, older age, duration of alcohol consumption, smoking, leukocytosis, hyperbilirubinemia, hypoalbuminemia, hyponatremia, and a larger volume of abscess were found to be significantly ( 0.05) associated with complications. On multivariate analysis, older age, duration of alcohol consumption, smoking, leukocytosis, hyperbilirubinemia, hypoalbuminemia, and hyponatremia were found to be significantly ( 0.05) associated with complications. Male gender, hypoalbuminemia, and larger volume of abscess were significantly ( < 0.05) associated with interventional treatment.
Older age, leukocytosis, hyperbilirubinemia, hypoalbuminemia, hyponatremia, chronic alcoholism, and smoking are independent factors significantly associated with complications in patients with ALA. Hypoalbuminemia, larger volume of abscess, and male gender are independent variables associated with the requirement of interventional therapy.
尽管近年来死亡率有所下降，但阿米巴肝脓肿（ALA）仍具有较高的发病风险。关于ALA严重程度、并发症或预后指标的研究数量有限，且在方法和结果上存在异质性。
分析了2016年1月至2017年10月期间收治的住院ALA患者的临床人口统计学资料、治疗方式及结局。对ALA患者并发症及介入治疗相关的可能预后因素进行回顾性分析。
分析了198例ALA患者的数据（平均年龄：45±12.1岁；男:女比例：193:5）。与非酒精性个体相比，酒精性个体的脓肿体积（503.1±391.2:300.2±305.8 mL）、肝酶升高及住院时间（11.98±5.75:10.23±4.1天）显著更高（P<0.05）。单因素分析发现，年龄较大、饮酒时间、吸烟、白细胞增多、高胆红素血症、低白蛋白血症、低钠血症及较大的脓肿体积与并发症显著相关（P<0.05）。多因素分析发现，年龄较大、饮酒时间、吸烟、白细胞增多、高胆红素血症、低白蛋白血症及低钠血症与并发症显著相关（P<0.05）。男性、低白蛋白血症及较大的脓肿体积与介入治疗显著相关（P<0.05）。
年龄较大、白细胞增多、高胆红素血症、低白蛋白血症、低钠血症、慢性酒精中毒及吸烟是与ALA患者并发症显著相关的独立因素。低白蛋白血症、较大的脓肿体积及男性是与介入治疗需求相关的独立变量。
