急性肾小球肾炎合并尿路感染患儿病原学及实验室指标的研究

发布时间：2018-11-28 07:56

【摘要】：目的分析小儿急性肾小球肾炎合并尿路感染患者的病原学特点和相关实验室指标变化。方法选取医院2014年10月-2016年5月收治的254例小儿急性肾小球肾炎病例,根据是否合并尿路感染分为尿路感染组130例和单纯肾炎组124例,比较两组在实验室检测指标上的差异,并对尿路感染组进行病原菌鉴定,分析病原菌的分布情况。结果急性肾小球肾炎患者合并尿路感染130例,感染率51.18%,尿路感染组患儿年龄、性别、高血压、下肢浮肿、血尿、尿蛋白水平、红细胞形态、颗粒管型与单纯肾炎患儿相比无统计学差异,尿路感染组患儿尿频74.62%、尿急76.15%、尿痛79.23%、肾区疼痛44.62%、小腹疼痛45.38%、高烧46.92%、白细胞计数升高81.54%、细胞管型54.62%显著高于单纯肾炎组(P0.05);急性肾小球肾炎合并尿路感染患儿共检测出病原菌174株,其中革兰阴性杆菌120株占68.97%,以大肠埃希菌为主;革兰阳性菌48株占27.59%,以屎肠球菌、粪肠球菌为主;真菌6株占3.45%。结论急性肾小球肾炎合并尿路感染并无特异性临床表现,早期进行实验室指标联合检测极为重要,且急性肾小球肾炎合并尿路感染主要病菌分布广泛,以革兰阴性杆菌感染为主。
[Abstract]:Objective to analyze the etiological characteristics and related laboratory indexes of children with acute glomerulonephritis complicated with urinary tract infection. Methods 254 children with acute glomerulonephritis from October 2014 to May 2016 were divided into urinary tract infection group (130 cases) and simple nephritis group (124 cases). The pathogens of urinary tract infection group were identified and the distribution of pathogens was analyzed. Results 130 patients with acute glomerulonephritis complicated with urinary tract infection, the infection rate was 51.18.The age, sex, hypertension, edema of lower extremities, hematuria, urinary protein level, erythrocyte morphology in urinary tract infection group. There was no statistical difference between the granular tube type and simple nephritis. In the urinary tract infection group, the urinary frequency was 74.62, the urination was 76.15, the urinal pain was 79.23, the renal area pain was 44.62, the lower abdomen pain was 45.38 and the fever was 46.92. The white blood cell count increased by 81.54 and 54.62% of the cells were significantly higher than that of the simple nephritis group (P0.05). 174 strains of pathogenic bacteria were detected in children with acute glomerulonephritis complicated with urinary tract infection, among which 120 strains of Gram-negative bacilli accounted for 68.97 strains, mainly Escherichia coli, 48 strains of Gram-positive bacteria accounted for 27.59%, mainly Enterococcus faecium and Enterococcus faecalis. 6 strains of fungi accounted for 3.45%. Conclusion there is no specific clinical manifestation in acute glomerulonephritis complicated with urinary tract infection. It is very important to test the laboratory indexes in the early stage, and the main bacteria of acute glomerulonephritis complicated with urinary tract infection are widely distributed. Gram-negative bacilli were the main infection.
【作者单位】：郑州大学附属郑州中心医院高新儿科;郑州大学附属郑州中心医院儿童康复科;郑州大学附属郑州中心医院高新神经内科;
【分类号】：R726.9

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