急性肾盂肾炎危险因素分析

Analysis of risk factors of acute pyelonephritis

目的探讨急性肾盂肾炎的危险因素。方法选取102例尿路感染患者,根据是否患有急性肾盂肾炎分为急性肾盂肾炎组(41例)和非急性肾盂肾炎组(61例)。分析比较两组患者的一般资料[糖尿病、尿路结石、前列腺增生、中晚期妊娠、长期卧床、(腰椎、胸椎)截瘫、膀胱颈硬化、尿潴留、留置尿管情况]及临床指标[糖化血红蛋白、空腹血糖、血清白蛋白、C反应蛋白(CRP)、降钙素原],并经Logistic回归分析急性肾盂肾炎危险因素。结果两组患者的前列腺增生、膀胱颈硬化、尿潴留、截瘫、糖尿病、留置尿管情况比较差异无统计学意义(P>0.05);两组患者的尿路结石、长期卧床、中晚期妊娠情况比较差异具有统计学意义(P<0.05)。急性肾盂肾炎组患者的空腹血糖(7.5±3.4)mmol/L、CRP(27.2±15.4)mg/L、降钙素原(2.8±1.7)mg/L均高于非急性肾盂肾炎组的(6.1±3.0)mmol/L、(8.2±3.9)mg/L、(0.4±0.2)mg/L,血清白蛋白(32.6±5.2)g/L低于非急性肾盂肾炎组的(37.2±4.7)g/L,差异均具有统计学意义(P<0.05);而组间糖化血红蛋白水平比较差异无统计学意义(P>0.05)。经Logistic回归分析显示,尿路结石、长期卧床、中晚期妊娠均为急性肾盂肾炎的高危因素(P<0.05)。结论尿路结石、长期卧床、中晚期妊娠是急性肾盂肾炎的高危因素;CRP、降钙素原可作为急性肾盂肾炎病情严重程度的预测指标;低蛋白血症既是肾盂肾炎的危险因素,也是疾病严重程度的指标。

Objective To investigate the risk factors of acute pyelonephritis. Methods A total of 102 urinary tract infection patients were divided by whether suffering from acute pyelonephritis into acute pyelonephritis group（41 cases） and non-acute pyelonephritis group（61 cases）. Analysis and comparison were made on general data [diabetes mellitus, urinary calculi, prostatic hyperplasia, middle and late pregnancy, long term bed rest, paraplegia（lumbar, thoracic）, bladder neck sclerosis, urinary retention, indwelling catheter conditions] and clinical indicators [glycosylated hemoglobin, fasting blood glucose, serum albumin, C reactive protein（CRP） and procalcitonin] in two groups. The risk factors of acute pyelonephritis were analyzed by Logistic regression. Results Both groups had no statistically significant difference in prostatic hyperplasia, bladder neck sclerosis, urinary retention, paraplegia, diabetes mellitus, and indwelling catheters conditions（P〉0.05）. Both groups had statistically significant difference in urinary calculi, long-term bed rest and middle and late pregnancy conditions（P〈0.05）. Acute pyelonephritis group had higher fasting plasma glucose as（7.5±3.4） mmol/L, CRP as（27.2±15.4） mg/L and procalcitonin as（2.8±1.7） mg/L than（6.1±3.0） mmol/L,（8.2±3.9） mg/L and（0.4± 0.2） mg/L in non-acute pyelonephritis group, and lower serum albumin as（32.6±5.2） g/L than（37.2±4.7） g/L in non-acute pyelonephritis group. Their difference was statistically significant（P〈0.05）. Both groups had no statistically significant difference in glycosylated hemoglobin levels（P〉0.05）. Logistic regression analysis showed that urinary calculi, long-term bed rest, middle and late pregnancy were high risk factors of acute pyelonephritis（P〈0.05）. Conclusion Urinary calculi, long-term bed rest, middle and late pregnancy are risk factors of acute pyelonephritis. CRP and procalcitonin can be used as predictors of the severity of acute pyelonephritis. Hypoproteinemia is both a risk factor for pyelonephritis and an indicator of disease severity.