原发性肾病综合征患者尿路感染危险因素分析

摘要

ObjectiveTo investigate the risk factors in primary nephrotic syndrome (PNS) patients with urinary tract infections (UTI) and provide clinical reference for the prevention of urinary tract infection. MethodFrom February 2007 to October 2013, the clinical data of 570 cases with PNS combined with 154 cases of UTI were retrospectively analyzed. Through the comparative analysis of two groups and the statistical analysis of related factors (including gender, age, complications, hormone dosage and immunosuppressor) in 154 cases of PNS combined with UTI, in order to ifnd the relations between various factors and primary nephrotic syndrome of urinary tract infections.Result154 cases were urinary tract infection in 570 cases with PNS, and the incidence of infection was 27.0%; compared with patients with no UTI complication, the content of the urine protein, serum protein, lipoprotein (a) [Lp(a)], IgG and low density lipoprotein (LDL) in patients with PNS combined with UTI had signiifcant changes (P<0.05). However, the content of cholesterol, high-density lipoprotein (HDL), IgM and IgA had no signiifcant differences (P>0.05). The results of single factor showed that the incidence of urinary tract infection was not related with age. In different stages of age, the incidence of children was greater than seniors and young adults. Two groups had signiifcant difference (P<0.05). Patients can improve the incidence of UTI (P<0.05) by the use of immunosuppressor and high doses of hormones and other complications.ConclusionLow serum proteinemia, low IgG emesis emia, high proteinuria, high LDL and (or) Lp(a) may indicate the incidence of primary nephrotic syndrome combined with urinary tract infections. Age, complications, with or without the use of immunosuppressor and concentration of hormone may be risk factors of causing urinary tract infection.%目的：探讨原发性肾病综合征（PNS）患者并发尿路感染（UTI）的危险因素，为诊断和治疗PNS并发UTI提供临床参考依据。方法对2007年2月至2013年10月本院收治的570例PNS患者中并发UTI的154例患者（试验组）的临床资料进行回顾性分析，随机选取154例单纯PNS患者作为对照组，比较两组患者各项生化指标，分析PNS并发UTI的相关单因素，包括性别、年龄、并发症、激素使用剂量以及免疫抑制剂的使用情况等，探究各项指标、单因素与PNS并发UTI的关系。结果570例PNS患者中154例并发UTI，感染发生率为27.0%；与对照组患者相比，试验组患者的尿蛋白、血清蛋白、脂蛋白a[Lp（a）]、免疫球蛋白G（IgG）和低密度脂蛋白（LDL）水平均有显著变化（P＜0.05）；而胆固醇、高密度脂蛋白（HDL）、免疫球蛋白M（IgM）和免疫球蛋白A （IgA）水平则无显著变化（P＞0.05）；单因素分析结果显示，UTI发生率与性别无关，不同年龄段的患者UTI发生率：少儿组＞老年组＞青壮年组，组间比较差异均有显著性（P＜0.05）；使用免疫抑制剂、高剂量的激素以及合并其他疾病均能显著提高UTI的发生率（P＜0.05）。结论低血清蛋白、低IgG血症、高蛋白尿、高LDL和（或）Lp（a）可能提示PNS并发UTI的发生。年龄、并发症、有无使用免疫抑制剂和激素使用浓度可能是引发UTI的危险因素。