肺脓肿患者的CT特征及脓胸的危险因素

CT features and risk factors of empyema in patients with pulmonary abscess

目的:调查肺脓肿患者的临床、胸部CT特征,探讨肺脓肿伴发脓胸危险因素。方法:回顾性分析收治的101例肺脓肿患者资料。根据是否并发脓胸分为脓胸组(25例)和无脓胸组(76例)。使用单因素和多因素Logistic回归分析比较肺脓肿相关脓胸危险因素。结果:肺脓肿相关脓胸的发生率为24.75%(25/101)。男性、糖尿病、胸膜炎症状、白细胞>10×10^(9)/L、白蛋白<25 g/L、痰培养阳性、脓肿直径>5 cm和跨肺叶肺脓肿是肺脓肿并发脓胸的潜在相关危险因素。多因素Logistic回归分析显示跨肺叶肺脓肿(OR=9.102,P=0.003),糖尿病(OR=9.066,P=0.003),脓肿直径>5 cm(OR=8.998,P=0.002)和胸膜炎症状(OR=5.395,P=0.015)是肺脓肿并发脓胸的独立危险因素。结论:跨肺叶肺脓肿、糖尿病、巨大肺脓肿和胸膜炎症状是肺脓肿患者发生脓胸的危险因素。

Objective To investigate the clinical and chest CT features of patients with pulmonary abscess and to explore the risk factors of pulmonary abscess with empyema.Method The data of 101 patients with lung abscess were analyzed retrospectively. According to whether empyema was complicated or not, it was divided into empyema group(25 cases) and non empyema group(76 cases). Univariate and multivariate logistic regression analysis were used to compare the risk factors of pulmonary abscess related empyema.Results The incidence of pulmonary abscess associated empyema was 24.75%(25/101). Male, diabetes, pleurisy symptoms, white blood cell>10×10^(9)/L, albumin <25 g/L, positive sputum culture, abscess>5 cm in diameter and trans lobar lung abscess were potential risk factors for pulmonary abscess complicated with empyema. Multivariate Logistic regression analysis showed that(OR=9.102,P=0.003), diabetes mellitus(OR=9.066,P=0.003), abscess diameter>5 cm(OR=8.998,P=0.002), and pleurisy symptoms(OR=5.395,P=0.015) were independent risk factors for pulmonary abscess complicated with empyema.Conclusion Trans pulmonary lobar abscess, diabetes, giant lung abscess and pleurisy are risk factors for empyema in patients with pulmonary abscess.