妊娠期无症状菌尿筛查的必要性  

Necessity of asymptomatic bacteriuria screening during pregnancy

作　　者：马睿 赵婷婷[1] 赫英东[2] Ma Rui;Zhao Tingting;He Yingdong(Department of Obstetrics and Gynecology,Peking University First Hospital,Ningxia Maternal and Child Health Care Hospital,Yinchuan 750011,China;Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院宁夏妇女儿童医院妇产科,银川750011 [2]北京大学第一医院妇产科,北京100034

出　　处：《中华围产医学杂志》2023年第5期406-410,共5页Chinese Journal of Perinatal Medicine

基　　金：中央高水平医院临床科研业务费资助(2022CR20)。

摘　　要：无症状菌尿(asymptomatic bacteriuria,ASB)是指无泌尿系统感染症状,但尿液中可以检测到一种或多种细菌繁殖的状态。早期研究显示,妊娠期未治疗的ASB可升高不良妊娠结局的风险。多项国际指南均推荐在妊娠期进行ASB筛查,并对存在ASB的孕妇进行治疗,以改善妊娠结局。然而,近年来的一些研究并未证实针对低危人群在妊娠期间筛查和治疗ASB可以改善妊娠结局,且目前我国产科临床实践中也未将ASB筛查作为常规产前检查的项目。本文回顾妊娠期ASB筛查的循证医学证据,分析各学术组织指南推荐内容及存在问题认为,基于我国国情,应针对所在地区的情况,开展相关临床研究,结合具体数据分析妊娠期ASB的基础风险和治疗获益,以期建立合理的妊娠期ASB筛查和治疗方案。现阶段建议对存在高危因素的孕妇筛查ASB。Asymptomatic bacteriuria(ASB)refers to the presence of one or more species of bacteria in an individual's urine without the symptoms of a urinary tract infection.Previous studies have shown that untreated ASB during pregnancy is associated with adverse pregnancy outcomes.Many international guidelines recommend a single screen-and-treat approach to ASB during pregnancy.Still,this approach has not been proven favorable to pregnancy outcomes in low-risk populations by recent studies.ASB screening is not a routine obstetric examination in clinical practice in China.Given this,this article will review the evidence of ASB screening during pregnancy and analyze the recommendations and existing problems in the guidelines from various academic organizations.Clinical studies should be carried out according to the situation in the region,and the basic risks and treatment benefits of ASB in pregnancy should be analyzed in combination with specific data to establish a proper screening and treatment plan for ASB during pregnancy.Screening for ASB is recommended for pregnant women with high-risk factors at this stage.

关 键 词：无症状感染 细菌尿 抗菌药 肾盂肾炎 妊娠结局 

分 类 号：R714.258[医药卫生—妇产科学]