摘要
目的分析类鼻疽重症患者的临床资料,探索重症类鼻疽患者的临床特征及其相关因素,为提高重症病例早期识别、降低死亡风险提供理论指导。方法收集海南某三甲医院2018年1月至2023年8月收治的80例类鼻疽患者的病例资料,对患者的基本信息、病史、临床特征、实验室检查等进行回顾性分析,归纳总结类鼻疽重症患者的临床特征,应用多因素Logistc回归分析其相关因素。结果80例病例中,有32例为重症病例,重症病例早期出现胸闷、胸痛及休克症状,24 h内出现感染指标升高、肝功能异常是重症类鼻疽患者的临床特征。糖尿病(OR=6.038,95%CI:1.070~34.083)、胸闷/胸痛(OR=20.375,95%CI:2.447~169.636)、休克(OR=1.756,95%CI:1.756~227.291)、天冬氨酸氨基转移酶(OR=1.001,95%CI:1.001~1.042)和直接胆红素(OR=1.013,95%CI:1.013~1.214)升高是类鼻疽发展为重症的相关因素。结论重症类鼻疽患者早期临床表现以胸闷、胸痛及休克为主,感染指标升高和肝功能异常是其重要的检验特征;糖尿病病史、胸闷/胸痛、休克以及入院时冬氨酸氨基转移酶和直接胆红素的升高为重症类鼻疽的相关因素,有助于早期识别重症类鼻疽。
This study was aimed at investigating the clinical features and risk factors for patients with severe melioidosis,to increase early diagnosis rates and decrease mortality.The clinical data for 80 patients with melioidosis treated in hospital between January 2018 and August 2023 were collected and analyzed with a logistic regression model.Among these patients,32 were diagnosed with severe melioidosis,and presented with symptoms such as chest tightness,chest pain,and shock in early stages.Common abnormalities found in severe melioidosis included high infectious indicators and liver dysfunction.Diabetes mellitus(OR=6.038,95%CI:1.070-34.083),chest tightness or chest pain(OR=20.375,95%CI:2.447-169.636),shock(OR=1.756,95%CI:1.756-227.291),high aspartic transaminase(OR=1.001,95%CI:1.001-1.042),and high direct bilirubin(OR=1.013,95%CI:1.013-1.214)were identified as risk factors for severe melioidosis.In conclusion,chest tightness,chest pain,shock,high infectious indicators,and liver dysfunction were significant clinical features of severe melioidosis.Risk factors such as diabetes mellitus,chest tightness or pain,shock,high aspartic transaminase,and high direct bilirubin may aid in the early diagnosis of severe melioidosis.
作者
叶丽香
蔡小霞
王晓闪
李敏香
YE Li-xiang;CAI Xiao-xia;WANG Xiao-shan;LI Min-xiang(Hainan Medical Univercity,Haikou 570216,China;The Second Affiliated Hospital of Hainan Medical Univercity,Haikou 570311,China)
出处
《中国人兽共患病学报》
CAS
CSCD
北大核心
2024年第11期1088-1093,共6页
Chinese Journal of Zoonoses
基金
海南省卫生健康科技创新联合项目(No.SQ2023WSJK0310)。
关键词
类鼻疽
伯克霍尔德菌
重症
临床特征
相关因素
melioidosis
Burkholderia
severe
clinical features
correlative factor
