Huang Lihua, Luo Jiao, Li Nan, Bao Zhenzhong, Gu Wei
Department of Infection Disease, The First Affiliated Hospital of Dali University, Dali, Yunnan, PR China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40914. doi: 10.1097/MD.0000000000040914.
This study aimed to compare the clinical characteristics of human fascioliasis and bacterial liver abscesses to provide a reference for the early and effective differentiation of these 2 diseases to avoid misdiagnosis. We retrospectively compared the epidemiological and clinical characteristics of 95 patients with human fascioliasis and 95 with bacterial liver abscess admitted to the First Affiliated Hospital of Dali University between January 2013 and March 30, 2023. The human fascioliasis group exhibited a higher proportion of female patients and a greater frequency of abdominal pain and lesions affecting both lobes of the liver. Additionally, eosinophil count, percentage of eosinophils, red blood cells, hemoglobin, total protein, albumin, carbohydrate antigen-125 (CA-125), CA-199, and CA-724 levels were elevated compared to the bacterial liver abscess group. Conversely, the proportion of patients with diabetes, duration of hospital stay, and the incidence of lesions affecting the right lobe of the liver, cavity formation, ascites, pleural effusion, white blood cells, total bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels were lower in the fascioliasis group compared to the bacterial liver abscess group. Furthermore, higher thrombin time and fibrinogen levels were observed in the fascioliasis group than in the bacterial liver abscess group (P < .05). Human fascioliasis predominantly occurs from August to November, while bacterial liver abscess exhibits a consistent incidence throughout the year. Human fascioliasis predominantly affects young women and demonstrates a seasonal pattern. It is associated with severe abdominal symptoms, widespread lesions, significantly elevated eosinophil levels, and seasonal incidence. Bacterial liver abscess predominantly affects elderly men with diabetes, and it is associated with localized lesions and severe inflammatory manifestations and occurs throughout the year.
本研究旨在比较人体肝片吸虫病和细菌性肝脓肿的临床特征，为这两种疾病的早期有效鉴别提供参考，以避免误诊。我们回顾性比较了2013年1月至2023年3月30日期间大理大学第一附属医院收治的95例人体肝片吸虫病患者和95例细菌性肝脓肿患者的流行病学和临床特征。肝片吸虫病组女性患者比例较高，腹痛及累及肝脏两叶的病变发生率较高。此外，与细菌性肝脓肿组相比，肝片吸虫病组的嗜酸性粒细胞计数、嗜酸性粒细胞百分比、红细胞、血红蛋白、总蛋白、白蛋白、糖类抗原125（CA-125）、CA-199和CA-724水平升高。相反，肝片吸虫病组糖尿病患者比例、住院时间以及累及肝右叶的病变发生率、腔隙形成、腹水、胸腔积液、白细胞、总胆红素、碱性磷酸酶、谷丙转氨酶、谷草转氨酶和γ-谷氨酰转肽酶水平均低于细菌性肝脓肿组。此外，肝片吸虫病组的凝血酶时间和纤维蛋白原水平高于细菌性肝脓肿组（P<0.05）。人体肝片吸虫病主要发生在8月至11月，而细菌性肝脓肿全年发病率较为一致。人体肝片吸虫病主要影响年轻女性，呈季节性发病模式。它与严重的腹部症状、广泛的病变、嗜酸性粒细胞水平显著升高以及季节性发病有关。细菌性肝脓肿主要影响患有糖尿病的老年男性，与局限性病变和严重的炎症表现有关，全年均可发生。
