上尿路结石合并糖尿病患者并发尿源性脓毒血症的危险因素

Risk factors for urosepsis in patients with upper urinary tract calculi and diabetes mellitus

目的探讨上尿路结石(upper urinary tract calculi,UUTC)合并糖尿病(diabetes mellitus,DM)患者并发尿源性脓毒血症的危险因素。方法回顾性分析248例UUTC合并DM患者的临床资料,将患者分为并发尿源性脓毒血症组(研究组,共97例)和未并发尿源性脓毒血症组(对照组,共151例)。将两组病例资料进行组间比较,应用logistic分析探讨UUTC合并DM患者并发尿源性脓毒血症的危险因素。结果两组在性别、年龄、来诊时症状(包括发热、腰腹疼痛、尿路刺激征)、尿白细胞、尿亚硝酸盐、尿葡萄糖及肾积水程度均差异有统计学意义(P<0.05)。多因素logistic分析发现女性、年龄增长、发热、尿白细胞、尿葡萄糖及重度肾积水可作为UUTC合并DM患者并发尿源性脓毒血症的独立预测因素。结论关注UUTC合并DM患者并发尿源性脓毒血症的危险因素,有助于早期识别高危患者,实施积极有效的干预措施,从而减少并发症,改善患者预后。

Objective To investigate the risk factors of urosepsis in patients with upper urinary tract calculi(UUTC)and diabetes mellitus(DM).Methods Retrospectively analysis was conducted on the clinical data of 248 patients diagnosed with UUTC and DM.The patients were divided into urosepsis group(study group,n=97)and non-urosepsis group(control group,n=151).The clinical data were compared between the two groups.Furthermore,logistic analysis was conducted to investigate the risk factors of urosepsis in patients with UUTC and DM.Results There were significant differences between the two groups in gender,age,symptoms(including fever,abdominal pain,urinary irritation symptoms),urine leukocytes(U-LEU),urine nitrite(U-NIT),urine glucose(U-GLU),and degree of hydronephrosis.Further multivariate logistic analysis found that female,older age,fever,U-LEU,U-GLU and severe hydronephrosis were independent risk predictors of urosepsis in patients with UUTC and DM.Conclusion Identification of risk factors of urosepsis in patients with UUTC and DM can be helpful for early identification of high-risk patients and implementation of effective intervention measures,so as to reduce complications and improve the prognosis of patients.