小儿急性肾小球肾炎与尿路感染的关系

Relationship between acute glomerulonephritis in children and urinary tract infections

目的探讨小儿急性肾小球肾炎(AGN)与尿路感染的关系,为小儿AGN和尿路感染的诊断治疗提供参考。方法回顾性分析2011年10月-2013年10月收治的82例急性肾小球肾炎患儿临床资料,探讨其临床特点,比较单纯急性肾小球肾炎患儿与合并尿路感染患儿的临床症状及实验室检查结果。结果 82例患儿中经中段尿培养阳性55例,阳性率为67.07%,其中以大肠埃希菌、聚团杆菌、大肠爱德华菌等革兰阴性杆菌为主,分别占58.18%、23.64%、16.36%;AGN合并尿路感染患儿尿频、尿急、尿痛、肾区叩击痛、下腹部疼痛、高热临床症状显著多于单纯AGN患儿(P<0.01);AGN合并尿路感染患儿细胞管型、白细胞计数≥10/高倍镜例数高于对照组(P<0.05)。结论 AGN患儿易并发尿路感染,临床实践中,应结合临床症状及实验室检查结果,给予及时诊断与治疗,从而降低尿路感染的发生率。

OBJECTIVE To explore the relationship between the acute glomerulonephritis （AGN ） in children and the urinary tract infections so as to provide guidance for the clinical diagnosis and treatment of AGN and urinary tract infections in the children .METHODS The clinical data of 82 children with acute glomerulonephritis who were treated in the hospital from Oct 2011 to Oct 2013 were retrospectively analyzed ,the clinical characteristics were explored ,and the clinical symptoms and the results of laboratory examination were observed and compared be‐tween the children with single acute glomerulonephritis and the children with acute glomerulonephritis complicated with urinary tract infections .RESULTS Of the 82 children ,55 cases were cultured positive for the midstream urine with the positive rate of 67 .07% ;the Escherichia coli ,Agglomerate bacilli ,and Edwards colon bacteria were the predominant species of gram‐negative bacilli ,accounting for 58 .18% ,23 .64% ,and 16 .36% ,respectively .The clinical symptoms of the AGN children complicated with urinary tract infections ,such as urinary frequency ,ur‐gency ,dysuria ,kidney percussion pain ,lower abdominal pain ,and fever ,were significantly more than those of the children with single AGN （P〈0 .01） .The number of the AGN children complicated with urinary tract infec‐tions with the cell casts ,while blood cells counts no less than 10/high magnification was larger than that of the control group （P〈0 .05） .CONCLUSIONS The urinary tract infections tend to occur in the AGN children .It is necessary to conduct the diagnosis and treatment on the basis of the clinical symptoms in combination with the re‐sults of laboratory examination so as to reduce the incidence of urinary tract infections .