糖尿病肾病等肾衰竭血液透析患者泌尿系感染临床分析  

Clinical analysis of urinary tract infections in hemodialysis patients with renal failure like diabetes and kidney disease

作　　者：陈碧玲[1] 姚平[1] 谭庆玲[1] 张惠[1] 汪茂荣[1] 

机构地区：[1]湖北民族学院附属民大医院内分泌核医学科,湖北恩施445000

出　　处：《中华医院感染学杂志》2015年第2期382-384,共3页Chinese Journal of Nosocomiology

基　　金：湖北省科技厅科技基金资助项目(EK2013D170014000426);湖北省民宗委基金资助项目(HBMW2012028)

摘　　要：目的分析慢性肾衰竭(CRF)维持性血液透析患者伴发泌尿系感染的治疗情况,探讨其相关危险因素。方法回顾性分析2011年1月-2013年12月血液透析中心CRF维持性血液透析患者579例临床资料,对发生泌尿系感染的患者按有无临床症状分为有症状组52例和无症状组48例,从年龄、性别、病原菌类型、有无合并其他疾病、有无临床感染症状等相关因素进行单因素分析和logistic回归分析,采用SPSS19.0统计软件进行数据处理。结果 100例泌尿系感染的CRF患者中检出病原菌以大肠埃希菌最多占21.0%,其次是金黄色葡萄球菌、肺炎克雷伯菌及表皮葡萄球菌,分别占17.0%、13.0%及13.0%;有症状组与无症状组病原菌分布差异无统计学意义;单因素分析结果显示,年龄、合并糖尿病肾病、慢性肾小球肾炎和高血压肾病、贫血、肿瘤相关肾病是CRF维持性血液透析患者发生泌尿系统感染的危险因素(P<0.05),logistic回归分析显示,年龄、合并糖尿病肾病、慢性肾小球肾炎、高血压肾病、贫血是发生泌尿系感染的独立危险因素(P<0.05)。结论 CRF维持性血液透析患者泌尿系感染起病隐匿,以大肠埃希菌和金黄色葡萄球菌为主,在老年且合并其他基础疾病患者中高发,应及早进行尿细菌培养检查,以早期发现、及早治疗,对高危人群应进行积极的预防性治疗。OBJECTIVE To analyze the treatment of urinary tract infections in chronic renal failure patients undergoing maintenance hemodialysis and explore the related risk factors.METHODS The clinical data of 579 chronic renal failure patients who underwent the maintenance hemodialysis from Jan 2011 to Dec 2013 were retrospectively analyzed,the patients with urinary tract infections were divided into the symptom group with 52 cases and the non-symptom group with 48cases;the univariate analysis and logistic regression analysis were performed for the related factors,including the age,genders,species of pathogens,complication of other diseases,and clinical symptom of infection;the data were statistically analyzed by using SPSS19.0software.RESULTS Among the pathogens isolated from the 100 chronic renal failure patients complicated with urinary tract infections,the Escherichia coli was the predominant species（21.0%）,followed by the Staphylococcus aureus（17.0%）,Klebsiella pneumoniae（13.0%）,and Staphylococcus epidermidis（13.0%）;there was no significance difference in the distribution of pathogens between the symptom group and the non-symptom group.The results of univariate analysis indicated that the age,diabetes,and kidney disease,complication of chronic glomerulonephritis,high blood pressure,anemia,and tumors were the risk factors for the urinary tract infections in the chronic renal failure patients undergoing maintenance hemodialysis（P〈0.05）;the logistic regression analysis showed that the age,diabetes,complication of chronic glomerulonephritis,high blood pressure,and anemia were the independent risk factors for the urinary tract infections（P〈0.05）.CONCLUSIONThe chronic renal failure patients have the hidden onset of urinary tract infections;the E.coli and S.aureus are the predominant species of pathogens.The elderly complicated with other underlying diseases are the population at high risk of the infections.It is necessary to conduct the urine culture in a timely manner so as to discover and treat

关 键 词：糖尿病肾病 慢性肾衰竭 血液透析 泌尿系感染 

分 类 号：R691.3[医药卫生—泌尿科学]