尿常规联合泌尿系统B超检查鉴别儿童原发性肾病综合征和尿路感染的诊断价值  

The diagnostic value of urinary routine combined with B-ultrasound of urinary system in distinguishing primary nephrotic syndrome and urinary tract infection in children

作　　者：陈月婵 张红升 CHEN Yuechan;ZHANG Hongsheng(Department of Laboratory Medicine,Affiliated Hospital of Henan Medical College,Henan Zhengzhou 451191)

机构地区：[1]河南医学高等专科学校附属医院检验科,郑州河南451191

出　　处：《医学检验与临床》2023年第3期25-28,共4页Medical Laboratory Science and Clinics

摘　　要：目的:探究尿常规联合泌尿系统B超检查鉴别儿童原发性肾病综合征(Primary Nephrotic Syndrome,PNS)和尿路感染的诊断价值。方法:选取2017年8月1日-2018年7月31日我院泌尿系科收诊的773例儿童作为此次的研究对象,PNS组患儿55例,尿路感染组患儿718例,两组均进行尿常规和泌尿系统B超检查,分析尿常规和泌尿系统B超检查鉴别儿童PNS和尿路感染的临床价值。结果:B超检查显示PNS组患儿双肾肿大,感染组患儿存在尿路结构异常,尿蛋白均呈阳性。感染组白细胞计数(white blood cell,WBC)、亚硝酸盐、白细胞酯酶阳性显著高于PSN组,差异具有统计学意义(P<0.05)。革兰阴性菌64.07%(460/718),主要为大肠埃希菌25.07%、铜绿假单胞菌18.94%和肺炎克雷伯菌16.71%;革兰阳性菌29.25%(210/718),主要为粪肠球菌10.86%、金黄色葡萄球菌8.21%和表皮葡萄球菌2.92%;真菌6.68%(48/718),主要为白色假丝酵母菌3.90%。WBC、亚硝酸盐、白细胞酯酶阳性联合泌尿系统B超检查鉴别儿童PSN和尿路感染的灵敏度和特异性显著优于单一方法鉴别,差异具有统计学意义(P<0.05)。结论:尿常规联合泌尿系统B超检查鉴别儿童原发性肾病综合征和尿路感染的诊断价值较高。Objective:To explore the diagnostic value of urinary routine combined with B-ultrasound of urinary system in distinguishing primary nephrotic syndrome(PNS)and urinary tract infection in children.Methods:773 children admitted to the Department of Urology in our hospital from August 1,2017 to July 31,2018 were selected as the study objects.There were55 children in the PNS group and 718 children in the urinary tract infection group.The group underwent urinary routine and urinary system B-ultrasound examination to analyze the clinical value of urinary routine and urinary system B-ultrasound in distinguishing PNS and urinary tract infection in children.Results:B-ultrasound examination showed that the children in the PNS group had enlarged kidneys,and the children in the infection group had abnormal urinary tract structure,and the urine protein was positive.The white blood cell count(WBC),nitrite and white blood cell esterase positive in the infection group were significantly higher than those in the PSN group,and the difference was statistically significant(P<0.05).Gram-negative bacteria 64.07%(460/718),mainly Escherichia coli 25.07%,Pseudomonas aeruginosa 18.94%and Klebsiella pneumoniae 16.71%;Gram-positive bacteria 29.25%(210/718),mainly It is 10.86% of Enterococcus faecalis,8.21%of Staphylococcus aureus and 2.92%of Staphylococcus epidermidis;Fungi 6.68%(48/718),mainly Candida albicans 3.90%.The sensitivity and specificity of WBC,nitrite,leukocyte esterase positive combined with urinary system B-ultrasound to distinguish children's PSN and urinary tract infection was significantly better than that of a single method,and the difference was statistically significant(P<0.05).Conclusion:Urine routine combined with B-ultrasound of the urinary system is of high diagnostic value in distinguishing children with primary nephrotic syndrome and urinary tract infection.

关 键 词：儿童 原发性肾病综合征 尿路感染 尿常规 泌尿系统B超检查 诊断价值 

分 类 号：R692[医药卫生—泌尿科学]