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血清白蛋白/球蛋白比值在化脓性肝脓肿患者中的临床意义

Clinical Significance of Serum Albumin/Globulin Ratio in Patients With Pyogenic Liver Abscess.

作者信息

Zhang Jia, Wang Tao, Fang Yi, Wang Mengzhou, Liu Wuming, Zhao Junzhou, Wang Bo, Wu Zheng, Lv Yi, Wu Rongqian

机构信息

National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

Front Surg. 2021 Nov 30;8:677799. doi: 10.3389/fsurg.2021.677799. eCollection 2021.

Abstract

Pyogenic liver abscess (PLA) remains a significant challenge for modern clinicians. Serum albumin/globulin ratio (AGR) can reflect the progress of many diseases. However, the clinical significance of AGR in PLA has not been evaluated. The aim of this study was to explore the effect of AGR on the clinical characteristic and prognosis in PLA patients. This retrospective study included 392 PLA patients who admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January, 2007 to December, 2016. The medical records on admission were collected. Compared with the healthy controls and the patients with extraperitoneal infection or non-infectious liver disease, PLA patients had lower levels of AGR. The mean level of AGR in PLA patients was 1.02 ± 0.25. There were 179 (45.4%) patients with AGR > 1.02 and 213 (54.6%) patients with AGR ≤ 1.02. The baseline data and treatment plans of PLA patients with high or low AGR were comparative. However, PLA patients with a low AGR had higher body temperature, leukocytes and neutrophils, lower hemoglobin, poorer liver and coagulation function, larger abscess diameter, higher positive rate of pus culture and proportion of , and were more susceptible to multiple bacteria. Moreover, PLA patients with a low AGR had more complications, including systemic inflammatory response syndrome (SIRS), peritoneal effusion and pleural effusion. And it also needs longer time for temperature normalization and hospital stay. In conclusion, PLA patients have lower AGR and lower AGR is associated with worse clinical manifestations, more complications and poorer prognosis. Thus, monitoring of AGR is of great clinical significance for evaluating the progress of PLA patients.

摘要

化脓性肝脓肿(PLA)对现代临床医生来说仍然是一项重大挑战。血清白蛋白/球蛋白比值(AGR)能够反映多种疾病的进展情况。然而,AGR在PLA中的临床意义尚未得到评估。本研究的目的是探讨AGR对PLA患者临床特征及预后的影响。这项回顾性研究纳入了2007年1月至2016年12月期间在西安交通大学第一附属医院住院的392例PLA患者。收集了入院时的病历资料。与健康对照组以及腹膜外感染或非感染性肝病患者相比,PLA患者的AGR水平较低。PLA患者的AGR平均水平为1.02±0.25。AGR>1.02的患者有179例(45.4%),AGR≤1.02的患者有213例(54.6%)。对AGR高或低的PLA患者的基线数据和治疗方案进行了比较。然而,AGR低的PLA患者体温、白细胞和中性粒细胞较高,血红蛋白较低,肝脏和凝血功能较差,脓肿直径较大,脓液培养阳性率和[此处原文似乎不完整]比例较高,且更容易感染多种细菌。此外,AGR低的PLA患者并发症更多,包括全身炎症反应综合征(SIRS)、腹腔积液和胸腔积液。而且体温恢复正常和住院时间也更长。总之,PLA患者的AGR较低,较低的AGR与更差的临床表现、更多的并发症和更差的预后相关。因此,监测AGR对评估PLA患者的病情进展具有重要的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3028/8669143/df3237a3b911/fsurg-08-677799-g0001.jpg

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