常用感染指标在新生儿尿路感染中诊疗价值的探讨  

Analysis of the value of common clinical indexes in the diagnosis and treatment of neonatal urinary tract infection

作　　者：卢伟明 梁凯玲 郭军飞 罗娅莎[1] 连佳敏 穆小萍[1] Lu Weiming;Liang Kailing;Guo Junfei;Luo Yasha;Lian Jiamin;Mu Xiaoping(Department of Clinical Laboratory,Guangdong Women and Children Hospital,Guangzhou Guangdong 511442,China;Medical Genetics Center,Guangdong Women and Children Hospital,Guangzhou Guangdong 511442,China)

机构地区：[1]广东省妇幼保健院检验科,广东广州511442 [2]广东省妇幼保健院医学遗传中心,广东广州511442

出　　处：《中华临床实验室管理电子杂志》2021年第1期34-37,共4页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

基　　金：广东省中医药局科研项目基金(20212025)。

摘　　要：目的探讨临床检测常用感染指标在新生儿尿路感染中的诊疗价值,为临床诊疗新生儿尿路感染提供有效的实验室依据。方法回顾性分析近5年于我院新生儿科住院治疗,并且有尿细菌培养记录的患儿实验室检测结果和临床信息,比较细菌培养阳性患儿和细菌培养阴性患儿实验室检测指标。结果近5年我院新生儿尿培养阳性率为5.15%(83/1611),尿培养阳性新生儿中男性比例高于女性(68.67%vs 31.33%);大肠埃希菌38株(45.78%)、肺炎克雷伯菌16株(19.28%)和肠球菌13株(15.66%)是最常见的致病菌。发热(24.10%)和黄疸(32.53%)是最常见的临床表现,但其发生率与尿培养阴性组无统计学差异;尿培养阳性组尿WBC显著高于尿培养阴性组,血WBC、CRP、PCT等实验室检测指标在尿培养阳性组和尿培养阴性组间无显著差异。结论血WBC、CRP、PCT等实验室常用检测指标在诊断新生儿尿路感染中的应用价值有限,在临床工作中应联合尿常规检测结果和尿细菌培养结果进行新生儿泌尿系统感染的诊疗。Objective To evaluate the diagnostic value of commonly used infectious indicators in neonatal urinary infectious diseases,which might provide an effective laboratory research basis for clinical diagnosis and treatment of neonatal urinary tract infection.Methods Retrospective analysis was conducted on the laboratory and clinical data of the children with urinary bacteria culture records hospitalized in our hospital in recent 5 years.Clinical data and laboratory data of urinary bacteria culture positive group and culture negative group were compared.Results The positive rate of urine culture in our hospital was 5.15%(83/1611)in recent 5 years,and the proportion of male neonates was higher than female neonates in urine culture positive neonates(68.67%vs 31.33%).Fever(24.10%)and jaundice(32.53%)were the most common clinical manifestations,but ther is no statistically different between groups;Urinary WBC count of culture positive group was significantly higher than culture negative group,but there is no statistical difference between groups in terms of blood WBC、CRP、PCT.Conclusion The diagnostic value of blood WBC、CRP、PCT are limited in the diagnosis of neonatal urinary tract infection,and combined use of routine urine test and urine culture is still a better diagnostic criterion for neonatal urinary tract infection.

关 键 词：新生儿尿路感染 尿常规指标 病原菌 感染指标 临床表现 

分 类 号：R722.1[医药卫生—儿科]