Clinical Characteristics Of Type 2 Diabetes Mellitus Complicated With Bacterial Liver Abscess

Objective: 1.To compare bacterial liver abscess(BLA)with type 2diabetes mellitus(T2DM)Objective to investigate the difference of clinical characteristics between T2 DM patients and non T2 DM patients,so as to strengthen the clinicians’ understanding of the disease,achieve early and correct diagnosis and treatment,and prevent the occurrence of serious adverse consequences;2.to explore and analyze the risk factors of T2 DM patients complicated with bla,so as to actively control the risk factors and provide reference for clinical prevention and treatment.Methods: 1.66 patients with T2 DM complicated with bla(group A),61 patients with bla(group B)and 73 patients with T2DM(Group C)were retrospectively analyzed in Yongzhou Central Hospital from January 2014 to December 2020.The general information,etiology,clinical symptoms and signs,laboratory examination,imaging,etiology,complications;2.treatment and outcome of group A and group B were collected and compared;3.The general data and laboratory indexes of group A and group C were collected and compared;4.SPSS 22.0 software was used for statistical analysis.Results:1.Comparison between group A(T2DM combined with BLA)and group B(BLA only): 1)generally speaking,the two groups were mostly middle-aged and elderly patients,but group A was older(P<0.05).2)In etiology,cryptogenic infection was common in both groups,but there was no difference;Blood infection was the second cause in group A,and bile infection was the second cause in group B(P<0.05).3)In terms of clinical symptoms and signs,fever was more common in group A,right upper abdominal pain and abdominal tenderness were less common(P<0.05).4)In laboratory results,anemia,hypoproteinemia,white blood cell count,percentage of neutrophils,aspartate aminotransferase,blood urea nitrogen,serum creatinine and fibrinogen in group A were higher than those in group B(P<0.05).5)On imaging,abscesses in the right lobe and single lobe of liver were common in both groups,but there was no difference;Group A was more prone to gas formation and multilocular separation,and most of them were 5-10 cm,some of them were larger than 10 cm,while group B was less than 5cm(P<0.05).6)The detection rate of blood culture in group A was higher than that in group B(P<0.05);Klebsiella pneumoniae was highly sensitive to the third and fourth generation cephalosporins,aminoglycosides and carbapenems.7)In terms of complications,group A was more likely to have severe complications(pleural effusion,ascites,sepsis,septic shock)(P<0.05).8)There was no difference in the treatment mode,effective rate and length of hospital stay between the two groups,but the hospitalization cost of group A was more(P<0.05).2.Group A(T2DM with BLA)was compared with group C(T2DM alone):1)single factor analysis showed that the proportion of biliary diseases in group A,the blood glucose of admission,fasting blood glucose and glycosylated hemoglobin were higher than that of group C,while albumin was lower than that of group C(P<0.05).2)multivariate logistic regression analysis showed that biliary tract disease,high admission random blood glucose and hypoproteinemia were independent risk factors of BLA in T2 DM.Conclusions:1.Klebsiella pneumoniae is the main pathogen of BLA.Compared with patients without T2 DM,patients with T2 DM and BLA have more severe infection and signs are not typical.2.Biliary tract disease,hyperglycemia and low albumin are independent risk factors of T2 DM complicated with BLA.