泌尿系结石患者急性泌尿系感染与肾功能不全、肾积水的关联性及临床意义探讨
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摘要
目的:探讨泌尿系结石患者急性泌尿系感染与急性肾功能不全、肾积水的关联性,并进一步分析其临床意义。方法:以2017年1月至10月本院收治的130例泌尿系结石患者为研究对象,分析伴和不伴急性肾功能不全、肾积水患者人口学指标(年龄、性别、BMI)、基线指标(SBP、SBP、DBP、FBG、TC、TG、HDL-C、LDL-C)、肾功能指标(BUN、Cr、UA)及急性泌尿系感染发生率的差异,并进一步分析泌尿系结石并发急性泌尿系感染的影响因素。结果:伴和不伴急性泌尿系感染、急性肾功能不全、肾积水患者的肾功能指标(BUN、Cr、UA)比较,差异具有统计学意义(P均<0.05);伴和不伴急性肾功能不全、肾积水患者的急性泌尿系感染发生率比较,差异具有统计学意义(P均<0.05);肾积水(OR=3.424,95%CI:0.152-6.710)、急性肾功能不全(OR=3.424,95%:1.151-6.215)是泌尿系结石患者并发急性泌尿系感染的独立危险因素(P均<0.05)。结论:泌尿系结石并发急性泌尿系感染患者肾功能存在明显的异常,泌尿系结石患者并发急性泌尿系感染与患者急性肾功能不全、肾积水存在一定的关联性,在泌尿系结石患者的临床诊治中,应给予急性肾功能不全、肾积水足够的重视。
Objective: To explore the relationship between acute urinary tract infection and acute renal insufficiency and hydronephrosis in patients with urinary calculi, and to further analyze its clinical significance. Methods: 130 patients with urinary calculi admitted to our hospital from January to October 2017 were studied. The demographic indices(age,sex, BMI), baseline indices(SBP, SBP, DBP, FBG, TC, TG, HDL-C, LDL-C), renal function indices(BUN, Cr, UA)and the incidence of acute urinary tract infection were analyzed, and the differences between patients with and without acute renal insufficiency and hydronephrosis were further analyzed. Influencing factors of urinary calculi complicated with acute urinary tract infection. Result: There were significant differences in the renal function indexes(BUN, Cr, UA)between patients with and without acute urinary tract infection, acute renal insufficiency and hydronephrosis(P < 0.05);there were significant differences in the incidence of acute urinary tract infection between patients with and without acute renal insufficiency and hydronephrosis(P <0.05); hydronephrosis(OR = 3.424, 95% CI: 0.152-6.710), acute. Sexual renal insufficiency(OR = 3.424, 95% CI: 1.151-6.215) is an independent risk factor for acute urinary tract infection in patients with urinary calculi(P < 0.05). Conclusion: There are obvious abnormalities in renal function in patients with urinary calculi complicated with acute urinary tract infection. Urinary calculi complicated with acute urinary tract infection is related to acute renal insufficiency and hydronephrosis. In the clinical diagnosis and treatment of urinary calculi, sufficient attention should be paid to acute renal insufficiency and hydronephrosis.
Objective: To explore the relationship between acute urinary tract infection and acute renal insufficiency and hydronephrosis in patients with urinary calculi, and to further analyze its clinical significance. Methods: 130 patients with urinary calculi admitted to our hospital from January to October 2017 were studied. The demographic indices(age,sex, BMI), baseline indices(SBP, SBP, DBP, FBG, TC, TG, HDL-C, LDL-C), renal function indices(BUN, Cr, UA)and the incidence of acute urinary tract infection were analyzed, and the differences between patients with and without acute renal insufficiency and hydronephrosis were further analyzed. Influencing factors of urinary calculi complicated with acute urinary tract infection. Result: There were significant differences in the renal function indexes(BUN, Cr, UA)between patients with and without acute urinary tract infection, acute renal insufficiency and hydronephrosis(P < 0.05);there were significant differences in the incidence of acute urinary tract infection between patients with and without acute renal insufficiency and hydronephrosis(P <0.05); hydronephrosis(OR = 3.424, 95% CI: 0.152-6.710), acute. Sexual renal insufficiency(OR = 3.424, 95% CI: 1.151-6.215) is an independent risk factor for acute urinary tract infection in patients with urinary calculi(P < 0.05). Conclusion: There are obvious abnormalities in renal function in patients with urinary calculi complicated with acute urinary tract infection. Urinary calculi complicated with acute urinary tract infection is related to acute renal insufficiency and hydronephrosis. In the clinical diagnosis and treatment of urinary calculi, sufficient attention should be paid to acute renal insufficiency and hydronephrosis.
引文
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[11]高逢彬.267例泌尿系结石患者结石成分及感控分析[D].山东大学,2015.
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[13]王敏,范立群,包志宏.体检人群中高尿酸血症与相关疾病的关系[J].武警医学,2016,23(3):241-242
[14]Zhu Y,Pandya BJ,choi HK.comorbidities of gout and hyperurice-mia in the Us general population:nHAnes 2013-2016[J].Am JMed,2016,125(7):679-687.
[15]Ando R,nagaya t,suzuki s,et al.Kidney stone formation is posi-tively associated with conventional risk factors for coronary heart dis-ease in Japanese men[J].JUrol,2016,189(4):1340-1346.
[16]梁叶萍,吴文起,曾国华.24h尿液成分与泌尿系统结石形成相关性的研究进展[J].东南大学学报(医学版),2016,30(4):666-667.
[17]木拉提·马合木提,张李晓,阿里木·太来提,等.高尿酸血症与泌尿系结石的关系研究[J].中国全科医学,2016,15(11):3787-3788
[18]scales c,smith A,Hanley J,et al.Prevalence of kidney stones inthe United statesJ[J].eur Urol,2015,62(1):160-165.
[19]陈少豪,于翔,吴宇鹏,等.根治性膀胱切除及尿流改道术后长期肾功能损害影响因素[J].临床泌尿外科杂志,2017,10(6):110-114.
[20]李政.复方金钱草颗粒结合西医治疗泌尿系结石患者的效果分析[J].系统医学,2016,14(3):307-312.
[21]李涛.输尿管软镜钬激光碎石术治疗药物排石治疗(Met)失败的输尿管上段结石[D].山东大学,2015.
[22]崔海军,田莉,张会民,等.泌尿系结石合并感染的临床病原菌分布分析[J].中国医院药学杂志,2016,12(3):71-76.
[23]stansbridge eM,Griffin DG,Walker V.Who makes uric acid stonesand why observations from a renal stones clinic[J].J clinPathol,2016,66(5):426-431
[2]茅善华.泌尿系结石相关梗阻性肾病的临床特征调查以及雌激素对其发展影响的相关研究[D].复旦大学,2013.
[3]郭强,李计.近代来粤医学传教士对结石病的研究--以广州博济医院为中心[J].南京中医药大学学报(社会科学版),2017,13(4):216-218.
[4]Liu H,Zhang XM,Wang YL,et al.Prevalence of hyperuricemia a-mong chinese adults:a national crosssectional survey using multi-stage,stratified sampling[J].J nephrol,2016,27(6):653-658
[5]甘星,许远兵.泌尿系结石并发急性感染的危险因素及病原学分析[J].浙江医学,2017,8(4):223-226.
[6]Perez R F,Hernandez B s,Herrero-Beites AM,et al.Risk factors associated with renal lithiasis during uricosuric treatmentof hyperuricemia in patients with gou[J].Arthritis care Res,2016,62(9):1299-1305
[7]中华泌尿学会泌尿系结石学组.泌尿系结石诊疗指南[J].中国实用内科杂志,2012,46(7):134-138
[8]上海慢性肾脏病早发现及规范化诊治与示范项目专家组.慢性肾脏病筛查诊断及防治指南[J].中国实用内科杂志,2017,37(1):28-34.
[9]陈山、高小峰、果宏峰,等.泌尿系感染诊断防治指南(2011年版)[J].实验与检验医学,2012,13(2):84-87
[10]Grignon A,Filion R,Filiatrauh D,et a1.Urinaly tract dilatation in utero:classifi cation and clinical applications[J].Radi-ology.2017.160(3):645-647.
[11]高逢彬.267例泌尿系结石患者结石成分及感控分析[D].山东大学,2015.
[12]oh Js,choi sW,Kuet Bs,et al.the association between uric acidlevel and urolithiasis on ultrasonography.Ann R heum Dis,2013,73(26):780-792.
[13]王敏,范立群,包志宏.体检人群中高尿酸血症与相关疾病的关系[J].武警医学,2016,23(3):241-242
[14]Zhu Y,Pandya BJ,choi HK.comorbidities of gout and hyperurice-mia in the Us general population:nHAnes 2013-2016[J].Am JMed,2016,125(7):679-687.
[15]Ando R,nagaya t,suzuki s,et al.Kidney stone formation is posi-tively associated with conventional risk factors for coronary heart dis-ease in Japanese men[J].JUrol,2016,189(4):1340-1346.
[16]梁叶萍,吴文起,曾国华.24h尿液成分与泌尿系统结石形成相关性的研究进展[J].东南大学学报(医学版),2016,30(4):666-667.
[17]木拉提·马合木提,张李晓,阿里木·太来提,等.高尿酸血症与泌尿系结石的关系研究[J].中国全科医学,2016,15(11):3787-3788
[18]scales c,smith A,Hanley J,et al.Prevalence of kidney stones inthe United statesJ[J].eur Urol,2015,62(1):160-165.
[19]陈少豪,于翔,吴宇鹏,等.根治性膀胱切除及尿流改道术后长期肾功能损害影响因素[J].临床泌尿外科杂志,2017,10(6):110-114.
[20]李政.复方金钱草颗粒结合西医治疗泌尿系结石患者的效果分析[J].系统医学,2016,14(3):307-312.
[21]李涛.输尿管软镜钬激光碎石术治疗药物排石治疗(Met)失败的输尿管上段结石[D].山东大学,2015.
[22]崔海军,田莉,张会民,等.泌尿系结石合并感染的临床病原菌分布分析[J].中国医院药学杂志,2016,12(3):71-76.
[23]stansbridge eM,Griffin DG,Walker V.Who makes uric acid stonesand why observations from a renal stones clinic[J].J clinPathol,2016,66(5):426-431