肝硬化患者创伤弧菌败血症与肺炎克雷伯杆菌败血症临床分析(1)
[摘要] 目的 比较肝硬化患者中创伤弧菌败血症与肺炎克雷伯杆菌败血症的临床特点及预后。 方法 回顾性分析2003年4月～2014年10月我院肝病科肝硬化患者院外发生创伤弧菌败血症患者(共17例)及发生肺炎克雷伯杆菌败血症患者(共42 例)的临床资料，比较两组患者的临床特点、实验室指标及转归。 结果 肝硬化患者中创伤弧菌败血症组和肺炎克雷伯杆菌败血症组在性别、年龄、病死率、发病到入院的时间、平均住院天数等方面差异无统计学意义(P>0.05)；在发生休克(χ2=6.778，P<0.05)、MODS(χ2=5.094，P<0.05)方面差异有统计学意义；实验室检查指标方面：碱性磷酸酶(Z=-3.606，P<0.05)、肌酐(Z=-2.092，P<0.05)、尿素氮(Z=-2.126，P<0.05)、肌酸激酶(Z=-2.804，P<0.05)及C反應蛋白(Z=-3.113，P<0.05)差异有统计学意义。 结论 肝硬化患者中创伤弧菌败血症与肺炎克雷伯杆菌败血症均进展迅速，均可有发热、休克、多器官功能衰竭等临床表现，但休克、多器官功能衰竭在创伤弧菌败血症患者中更易发生。在实验室检查方面，均可以引起血象升高、肾功能损害及肌炎等，但创伤弧菌败血症患者更容易发生肾功能损害及肌炎。
[关键词] 创伤弧菌；感染；肝硬化；肺炎克雷伯杆菌；败血症
[中图分类号] R575；R516 [文献标识码] A [文章编号] 1673-9701(2016)33-0025-05
[Abstract] Objective To compare the clinical characteristics and prognosis of vibrio vulnificus septicemia and Klebsiella pneumoniae septicemia in the patients with liver cirrhosis. Methods Clinical data of 17 patients infected with community-acquired septicemia caused by vibrio vulnificus and 42 patients with septicemia caused by Klebsiella pneumoniae from April 2003 to October 2014 in the Department of Hepatopathy in our hospital were retrospectively analyzed. The clinical characteristics， laboratory indices and outcomes of the two groups were compared. Results There were no statistically significant differences in gender， age， mortality rate， the duration from disease onset to admission and average length of stay between vibrio vulnificus septicemia group and Klebsiella pneumonia septicemia group in the patients with liver cirrhosis (P>0.05)； there was significant difference in shock (χ2=6.778， P<0.05) and MODS (χ2=5.094， P<0.05)； indices of laboratory examination indicated that alkaline phosphatase(Z=-3.606， P<0.05)， creatinine (Z= -2.092， P<0.05)， urea nitrogen(Z=-2.126， P<0.05) and creatine kinase (Z=-2.804， P<0.05) and C-reactive protein (Z= -3.113， P<0.05) were statistically different. Conclusion Septicemia caused by vibrio vulnificus and Klebsiella pneumoniae in the patients with liver cirrhosis are progressing rapidly. They may have fever， shock， multiple organ failure and other clinical manifestations. But shock and multiple organ failure are more likely to occur in the patients with septicemia caused by vibrio vulnificus. In laboratory examinations， the septicemia can cause elevated blood picture， kidney damage and myositis. However， patients with septicemia caused by vibrio vulnificus are more prone to renal impairment and myositis.
[Key words] Vibrio vulnificus； Infection； Liver cirrhosis； Klebsiella pneumoniae； Septicemia (郑小庆 盛吉芳 邓勤智)
[关键词] 创伤弧菌；感染；肝硬化；肺炎克雷伯杆菌；败血症
[中图分类号] R575；R516 [文献标识码] A [文章编号] 1673-9701(2016)33-0025-05
[Abstract] Objective To compare the clinical characteristics and prognosis of vibrio vulnificus septicemia and Klebsiella pneumoniae septicemia in the patients with liver cirrhosis. Methods Clinical data of 17 patients infected with community-acquired septicemia caused by vibrio vulnificus and 42 patients with septicemia caused by Klebsiella pneumoniae from April 2003 to October 2014 in the Department of Hepatopathy in our hospital were retrospectively analyzed. The clinical characteristics， laboratory indices and outcomes of the two groups were compared. Results There were no statistically significant differences in gender， age， mortality rate， the duration from disease onset to admission and average length of stay between vibrio vulnificus septicemia group and Klebsiella pneumonia septicemia group in the patients with liver cirrhosis (P>0.05)； there was significant difference in shock (χ2=6.778， P<0.05) and MODS (χ2=5.094， P<0.05)； indices of laboratory examination indicated that alkaline phosphatase(Z=-3.606， P<0.05)， creatinine (Z= -2.092， P<0.05)， urea nitrogen(Z=-2.126， P<0.05) and creatine kinase (Z=-2.804， P<0.05) and C-reactive protein (Z= -3.113， P<0.05) were statistically different. Conclusion Septicemia caused by vibrio vulnificus and Klebsiella pneumoniae in the patients with liver cirrhosis are progressing rapidly. They may have fever， shock， multiple organ failure and other clinical manifestations. But shock and multiple organ failure are more likely to occur in the patients with septicemia caused by vibrio vulnificus. In laboratory examinations， the septicemia can cause elevated blood picture， kidney damage and myositis. However， patients with septicemia caused by vibrio vulnificus are more prone to renal impairment and myositis.
[Key words] Vibrio vulnificus； Infection； Liver cirrhosis； Klebsiella pneumoniae； Septicemia (郑小庆 盛吉芳 邓勤智)