婴儿泌尿道感染的临床特点分析

Clinical Characteristics of Urinary Tract Infection in Infants

目的分析婴儿泌尿道感染(UTI)的临床特点。方法选取2018年6月至2020年3月吉安市妇幼保健院收治的初次泌尿道感染患儿85例。按照患儿年龄段不同分为2组:婴儿组55例,年龄1个月~1岁;幼儿组30例,年龄3~7岁。比较2组临床表现[发热、尿路刺激征、尿液异常情况(血尿、尿混浊)、胃肠道症状(恶心、呕吐、腹痛)、精神状态及纳差情况]、实验室结果[降钙素原(PCT)、C反应蛋白(CRP)、血沉(ESR)、白细胞(WBC)、肝功能损害及心肌损害率]、影像学检查情况、误诊率及复发率。结果与幼儿组比较,婴儿组发热、纳差、精神差等症状的发生率显著升高(均P<0.05);与幼儿组比较,婴儿组血WBC、CRP、PCT、肝功能损害及心肌损害异常率均显著升高(均P<0.05);与幼儿组比较,婴儿组影像学检查尿路结构异常率显著升高(P<0.05);与幼儿组比较,婴儿组误诊率及复发率均显著升高(均P<0.05)。结论婴儿UTI多表现为发热性泌尿道感染,临床表现缺乏特异性,以全身症状为主,局部症状无法表述,误诊率高,需注意尿常规检测;婴儿UTI合并泌尿系器质性或功能异常者较多,需及时进行影像学检查,婴儿UTI有一定复发率,需加强随访。

Objective To analyze the clinical characteristics of urinary tract infection(UTI)in infants.Methods A total of 85 primary UTI children admitted to Ji’an Maternal and Child Health Hospital from June 2018 to March 2020 were divided into two groups:55 infants aged 1 month to 1 year and 30 children aged 3 to 7 years.Clinical manifestations(fever,urinary irritation,hematuria,cloudy urine,nausea,vomiting,abdominal pain,mental state and anorexia),laboratory results(procalcitonin(PCT),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),white blood cell(WBC),liver function impairment and myocardial damage),imaging findings,misdiagnosis rate,and recurrence rate were compared between the two groups.Results Compared with child group,incidences of fever,anorexia,energielos,liver function impairment,myocardial damage and urinary tract deformity,levels of WBC,CRP and PCT,and rates of misdiagnosis and recurrence significantly increased in infant group(P<0.05).Conclusion The UTI in infants usually manifests as febrile UTI,which lacks specificity and mainly shows systemic symptoms.Infantile UTI is associated with a high rate of misdiagnosis and routine urine testing is required.Imaging examination should be performed in time because many infants with UTI have urinary organic or functional abnormalities.In addition,follow-up should be strengthened due to the recurrence of UTI.