80例肾移植术后泌尿系统感染患者的临床资料分析

发布时间：2018-04-09 22:30

本文选题：肾移植　切入点：泌尿系感染　出处：《山东医药》2015年07期

【摘要】：目的分析肾移植患者泌尿系统感染(UTI)的相关影响因素及其特点。方法 80例肾移植术后UTI患者,按年龄段分为低龄组(22~40岁)和高龄组(41~69岁),对两组性别、年龄、发生UTI次数、尿液微生物检查、透析类型、血清肌酐、免疫诱导、免疫抑制、发生移植肾急性排斥反应、有无糖尿病史、发生慢性移植肾肾病、发生移植肾失功情况进行比较。结果 80例肾移植术后UTI患者中男35例、女45例,女性患者UTI发病率较男性高(P0.05);其中75.0%(60/80)患者出现至少2次UTI;45.0%(36/80)患者临床表现不典型,32.5%(26/80)患者无任何症状;尿液微生物检查发现39例份尿标本细菌阳性,大肠埃希菌占41.0%(16/39),30.0%(24/80)患者尿液中未找到任何致病菌。肾移植术前血液透析替代治疗的尿毒症患者术后UTI的发生率为70.0%(56/80)。肾移植术后2例膀胱输尿管反流、3例前列腺增生、5例移植肾结石患者均发生UTI。高龄组(66.3%,53/80)UTI患者的发生率高于低龄组(33.8%,27/80),且有糖尿病史、慢性移植肾肾病发生率、移植肾失功发生率均高于低龄组(P均0.05)。结论年龄、性别、糖尿病、术后输尿管膀胱反流、前列腺增生、移植肾结石及术前长时间血液透析等都是肾移植患者发生UTI的高危因素,且肾移植患者UTI具有高发性、反复发作性、临床表现不典型性、以大肠埃希菌为主要致病菌等特点。高龄组肾移植UTI患者合并糖尿病易增加慢性移植肾肾病以及移植肾失功发生的风险。
[Abstract]:Objective to analyze the related factors and characteristics of urinary tract infection (UTI) in renal transplantation patients.Methods Eighty patients with UTI after renal transplantation were divided into two groups according to their age groups: low age group (22 ~ 40 years old) and elderly group (41 ~ 69 years old). Sex, age, frequency of occurrence of UTI, urine microbiological examination, type of dialysis, serum creatinine, immune induction and immunosuppression were measured.Acute allograft rejection, history of diabetes, chronic renal allograft nephropathy and renal allograft dysfunction were compared.Results among the 80 UTI patients after renal transplantation, 35 were male and 45 female. The incidence of UTI in female patients was higher than that in male patients (P 0.05).Urine microorganism examination found that 39 urine samples were positive for bacteria. Escherichia coli accounted for 41. 0% 16 / 39 / 30. 0%. No pathogenic bacteria were found in urine of 39 cases.The incidence of UTI in uremic patients undergoing hemodialysis replacement therapy before renal transplantation was 70. 0%.UTI was found in 2 cases of bladder and ureter reflux 3 cases of benign prostatic hyperplasia and 5 cases of renal allograft after renal transplantation.The incidence of 53 / 80 UTI in the elderly group was higher than that in the younger age group (27 / 80), and the history of diabetes, the incidence of chronic renal allograft nephropathy and the incidence of allograft dysfunction were all higher than those in the younger group (P < 0.05).Conclusion Age, sex, diabetes, postoperative ureteral bladder reflux, prostatic hyperplasia, renal stone grafts and long time hemodialysis before operation are all high risk factors for UTI in renal transplantation patients, and UTI is high in renal transplantation patients.Repeated attacks, atypical clinical manifestations, Escherichia coli as the main pathogenic bacteria and other characteristics.The risk of chronic renal allograft nephropathy and renal allograft dysfunction was increased in elderly UTI patients with diabetes mellitus.
【作者单位】：南方医科大学南方医院;
【分类号】：R699.2

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