24小时尿蛋白、尿液亚硝酸盐、尿沉渣细菌定量计数诊断肾病综合征合并尿路感染的价值  

The 24 hour urine output,urine nitrite and quantitative count of urinary sediment bacteria for diagnosis of urinary tract infection in patients with nephrotic syndrome

作　　者：杨琦[1] 郭楠[1] 栗晓斌 李洪敏 武玉鑫 宋天佳 刘尚建[2] 姚兴伟[1] YANG Qi;GUO Nan;LI Xiaobin;LI Hongmin;WU Yuxin;SONG Tianjia;LIU Shangjian;YAO Xingwei(Department of Clinical Laboratory,Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院检验科,100700 [2]北京中医药大学东直门医院肾病内分泌科,100700

出　　处：《浙江医学》2024年第23期2521-2526,共6页Zhejiang Medical Journal

基　　金：北京中医药大学东直门医院院级课题(2023DZMCR-047-01)。

摘　　要：目的探讨24小时尿蛋白(24 hUP)、尿液亚硝酸盐、尿沉渣细菌定量计数诊断肾病综合征(NS)合并尿路感染(UTI)的价值。方法回顾性选取2021年10月至2023年10月北京中医药大学东直门医院住院的NS患者380例,根据是否合并UTI分为感染组96例和无感染组284例。比较两组患者临床资料、24 hUP、尿液亚硝酸盐及尿沉渣细菌定量计数阳性率,分析24 hUP与尿液亚硝酸盐、尿沉渣细菌定量计数的相关性,比较治疗前后24 hUP、尿液亚硝酸盐及尿沉渣细菌定量计数变化情况,分析24 hUP、尿液亚硝酸盐、尿沉渣细菌定量计数对NS合并UTI的影响及诊断价值。结果感染组年龄、血肌酐(Scr)水平高于无感染组,血清IgG水平低于无感染组(均P<0.05);感染组24 hUP水平、尿液亚硝酸盐阳性率、尿沉渣细菌定量计数阳性率均高于无感染组(均P<0.05);感染组患者24 hUP与尿液亚硝酸盐、尿沉渣细菌定量计数呈正相关(rs=0.577、0.610,均P<0.05);两组患者治疗后24 hUP、尿液亚硝酸盐、尿沉渣的菌定量计数阳性率均低于治疗前(均P<0.05),感染组治疗前、治疗后24 hUP、尿液亚硝酸盐、尿沉渣细菌定量计数阳性率均高于无感染组(均P<0.05);校正后logistic回归分析显示,24 hUP、尿液亚硝酸盐、尿沉渣细菌定量计数均是NS合并UTI的独立影响因素(均P<0.05);24 hUP、尿液亚硝酸盐、尿沉渣细菌定量计数联合诊断NS合并UTI的AUC为0.926(95%CI:0.894~0.950),明显优于各指标单独诊断。结论NS合并UTI患者中24 hUP水平升高与尿液亚硝酸盐、尿沉渣细菌定量计数呈正相关,三者联合检测有助于提高NS合并UTI的诊断率。Objective To evaluate the application of 24 hour urinary protein(24 hUP)and the quantitative count of urine nitrite and urinary sediment bacteria for diagnosis of urinary tract infection(UTI)in patients with nephrotic syndrome(NS)complicated with.Methods A total of 380 NS patients admitted in Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from October 2021 to October 2023 were enrolled,including 96 cases with UTI(infection group)and 284 cases without UTI(non-infection group).The clinical data,24 hUP,urinary nitrite levels,and the positive rate of quantitative bacterial count in urine sediment were compared between the two groups.The correlation among 24 hUP,urine nitrite levels and positive rate of quantitative bacterial count in urine sediment,was analyzed.The changes of above indicators were compared before and after treatment,and their diagnostic value was evaluated.Results The age and serum creatinine(Scr)levels in the infection group were higher,and the serum IgG level was lower than those in the non-infection group(both P<0.05).The 24 hUP level,positive rate of urine nitrite,and positive rate of quantitative urine sediment bacterial count in the infection group were all higher than those in the non-infection group(all P<0.05).The 24 hUP was positively correlated with urine nitrite and the positive rate of quantitative bacterial count in urine sediment in the infection group(rs=0.577,0.610,both P<0.05).The positive rates of 24 hUP,urine nitrite,and the positive rate of quantitative bacterial count in urine sedirment in both groups were lower after treatment than those before treatment(all P<0.05).The positive rates of UP,urine nitrite,and the positive rate of quantitative bacterial count in urine sediment in the infection group were higher than those in the non-infection group before and after treatment(all P<0.05).The 24 hUP in the infection group was positively correlated with both urine nitrite levels and the positive rate of quantitative bacterial count in urine sediment in uri

关 键 词：肾病综合征 尿路感染 24小时尿蛋白水平 尿液亚硝酸盐 尿沉渣细菌定量计数 

分 类 号：R692[医药卫生—泌尿科学] R691.3[医药卫生—外科学]