摘要： 目的 评价儿童泌尿道感染再发率以及危险因素，为儿童反复泌尿道感染诊疗提供依据。方法 回顾性分析我院小儿肾脏科2015年1月1日至2020年1月1日期间因泌尿道感染住院患儿777例的临床资料，包括年龄、性别、是否存在便秘、是否为过敏体质、IgA水平、IgG水平、血肌酐、尿培养病原菌、血红蛋白水平以及泌尿系统彩超、排泄性膀胱尿路造影、静脉肾盂造影结果。所有患者随访至少1年，或截止至发生再发性泌尿道感染。采用logistic回归分析再发性泌尿系感染的危险因素。结果 777例患儿中，96例（12.4%）发生了再发性泌尿道感染。再发性泌尿道感染组患儿泌尿系统畸形、过敏体质、便秘、贫血、IgA水平减低者比例明显高于非再发组。logistic分析提示，泌尿系统畸形（OR=9.637，95%CI：3.548~20.213，P=0.001）、过敏体质（OR=2.175，95%CI：1.222~3.871，P=0.008）和贫血（OR=2.876，95%CI：1.630~5.075，P=0.001）是再发性泌尿道感染的独立危险因素。结论 约1/8初次泌尿道感染患儿会发生再发性泌尿道感染，再发性泌尿道感染的危险因素是泌尿系统畸形、过敏体质和贫血。

儿童再发性泌尿道感染危险因素分析

尹璐, 杜悦, 王秀丽, 赵成广, 郑悦

中国医科大学附属盛京医院小儿肾脏风湿免疫科, 沈阳 110004

收稿日期:2020-03-26出版日期:2021-01-30发布日期:2021-01-06
通讯作者:杜悦E-mail:duy@sj-hospital.org
作者简介:尹璐(1988-),女,主治医师,硕士.



关键词: 儿童, 泌尿道感染, 泌尿系统畸形, 过敏
Abstract: Objective To evaluate the rate of and risk factors for recurrent urinary tract infection in children at a single center,in order to provide a basis for its diagnosis and treatment. Methods The clinical data of 777 inpatients with urinary tract infection in the Pediatric Nephrology Department of Shengjing Hospital from January 1,2015 to January 1,2020 were analyzed retrospectively,including age,sex,constipation status,allergic constitution,IgA and IgG levels,serum creatinine level,urine culture pathogen,hemoglobin level,urinary color ultrasound,excretory cystourethrography,intravenous pyelography. All patients were followed up for at least 1 year or till recurrent urinary tract infection occurred during the follow-up period. Logistic regression analysis was used to assess the risk factors for recurrent urinary tract infection. Results Of the 777 cases,96 (12.4%) developed recurrent urinary tract infection. The proportion of those with urinary malformation,allergic constitution,constipation,anemia,and decreased IgA level in the recurrent urinary tract infection group was significantly higher than that in the non-recurrent group. Logistic analysis showed that urinary malformation,allergic constitution,and anemia were independent risk factors for recurrent urinary tract infection (OR=9.637,95%CI:3.548-20.213,P=0.001;OR=2.175,95%CI:1.222-3.871,P=0.008;OR=2.876,95%CI:1.630-5.075,P=0.001). Conclusion one-eighth of patients with primary urinary tract infection may develop a recurrence. The risk factors for recurrent urinary tract infection are urinary malformation,allergic constitution,and anemia.
Key words: children, urinary tract infection, urinary malformation, allergic constitution
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