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Reverse ag ratio7/1/2023 ![]() ![]() In this study, the PLA patients had lower AGR level, compared with the healthy controls and the patients with extraperitoneal infection and non-infectious liver disease. This cut-off value was similar to previous studies ( 25– 27). There were 213 (54.3%) PLA patients in the low-AGR group, and 179 (45.7%) PLA patients in the high-AGR group. Compared with healthy controls and patients with extraperitoneal infection or non-infectious liver disease, PLA patients had lower level of AGR ( Figure 2A, P 1.02). As showed in Supplementary Table 2, the most included extraperitoneal infection was pulmonary infection (26, 68.4%), and the most included non-infectious liver disease was hepatic hemangioma (16, 57.1%). However, other factors were not matched in this study. To explore the effect of PLA on serum AGR, the AGR levels of healthy controls ( n = 50) and the patients with PLA ( n = 392), extraperitoneal infection ( n = 38) and non-infectious liver disease ( n = 28) were collected and the three controls were matched with the PLA patients by age and gender ( Supplementary Table 1, P > 0.05). The aim of this study is to explore the effect of AGR on the clinical characteristics and prognosis of PLA patients. As a serious infectious disease of the liver, PLA was associated with the decreased albumin and increased globulin, however, the clinical significance of AGR in PLA patients remains largely unknown. Several recent studies have found that serum albumin/globulin ratio (AGR) can predict the prognosis of various diseases, including cancers, chronic kidney disease, heart failure, and peritoneal dialysis ( 17– 21). Globulin, known as immune globulin, is mainly used to evaluate the overall status of immune and inflammatory responses ( 14– 16). In addition, albumin also plays an important role in a variety of diseases ( 12, 13). ![]() Albumin has a variety of physiological functions, such as maintaining osmotic pressure, transporting nutrient contents (fatty acids, bile acids, and cholesterol), scavenging free oxygen radicals ( 8– 11). Albumin is mainly synthesized in the liver and its level can reflect liver function. The serum protein is composed by albumin (ALB) and globulin (GLO). Therefore, PLA remains an important challenge for today's clinicians. Many factors, such as malnutrition ( 3), diabetes ( 4, 5), hepatobiliary diseases ( 6), or accompanied by shock, low hemoglobin, high urea nitrogen, and multiple lesions in the liver ( 7) can influence the prognosis of PLA. However, the PLA incidence is still rising due to the aging of the population, the use of immunosuppressive agents, and the increase of diabetes ( 2). The advent of modern antibiotics and intensive care techniques have dramatically reduced the mortality of PLA patients. PLA had a high morbidity and mortality in the past ( 1). Pyogenic liver abscess (PLA) is a type of pyogenic infection in the liver, which can be life-threatening without appropriate treatment. Thus, monitoring of AGR is of great clinical significance for evaluating the progress of PLA patients. ![]() In conclusion, PLA patients have lower AGR and lower AGR is associated with worse clinical manifestations, more complications and poorer prognosis. And it also needs longer time for temperature normalization and hospital stay. Moreover, PLA patients with a low AGR had more complications, including systemic inflammatory response syndrome (SIRS), peritoneal effusion and pleural effusion. However, PLA patients with a low AGR had higher body temperature, leukocytes and neutrophils, lower hemoglobin, poorer liver and coagulation function, larger abscess diameter, higher positive rate of pus culture and proportion of Escherichia coli, and were more susceptible to multiple bacteria. The baseline data and treatment plans of PLA patients with high or low AGR were comparative. The mean level of AGR in PLA patients was 1.02 ± 0.25. Compared with the healthy controls and the patients with extraperitoneal infection or non-infectious liver disease, PLA patients had lower levels of AGR. The medical records on admission were collected. This retrospective study included 392 PLA patients who admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January, 2007 to December, 2016. The aim of this study was to explore the effect of AGR on the clinical characteristic and prognosis in PLA patients. However, the clinical significance of AGR in PLA has not been evaluated. Serum albumin/globulin ratio (AGR) can reflect the progress of many diseases. Pyogenic liver abscess (PLA) remains a significant challenge for modern clinicians. ![]()
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