摘要
目的分析并比较神经源性膀胱(NB)患者尿路感染(UTI)和无症状菌尿(ABU)的特征与诊治效果。方法回顾性收集2015年3月至2023年10月潍坊市妇幼保健院和青岛市胶州中心医院收治的142例NB患者资料,其中伴有UTI 25例(UTI组),伴有ABU 117例(ABU组)。分析并比较两组患者临床特征及抗感染治疗后的预后情况。采用ROC曲线评估镜检白细胞计数(WBC)对NB患者感染类型的诊断效能。结果两组患者性别、年龄、BMI、膀胱受累时间比较差异均无统计学意义(均P>0.05)。UTI组行间歇性导尿患者比例、复发UTI患者比例均小于ABU组,WBC高于ABU组,差异均有统计学意义(均P<0.05)。两组肾积水程度比较,差异有统计学意义(P<0.05)。UTI组患者均接受抗感染治疗,治愈14例、好转9例、未愈2例;50例ABU组患者接受抗感染治疗,治愈41例、好转6例、未愈3例;两组抗感染治疗效果比较,差异有统计学意义(P<0.05)。ROC曲线提示WBC截断值为21.5/μL时区分UTI和ABU的效能较好(AUC=0.743,95%CI:0.657~0.829)。结论相比ABU患者,UTI患者更易复发UTI,间歇导尿率更高,尿常规WBC更高,肾积水程度更重,预后也较差。镜检WBC≥21.5/μL可有效鉴别UTI和ABU。
Objective To analyze and compare the characteristics,diagnosis and treatment of urinary tract infection(UTI)and asymptomatic bacteriuria(ABU)in patients with neurogenic bladder(NB).Methods A retrospective analysis was conducted on 142 patients with NB admitted to Weifang Maternal and Child Health Hospital and Jiaozhou Central Hospital in Qingdao between March 2015 and October 2023.Among which,25 cases were diagnosed with UTI(UTI group),while 117 had ABU(ABU group).The clinical characteristics and prognosis of the two groups after anti-infection treatment were analyzed and compared.The diagnostic accuracy of microscopic white blood cell count(WBC)for distinguishing types of infections in NB patients was assessed using ROC curve analysis.Results There were no statistically significant differences in gender,age,BMI,and bladder involvement time between the two groups(all P>0.05).The proportion of patients receiving intermittent catheterization and the proportion of patients with recurrent UTI in UTI group were lower than those in ABU group,and the WBC was higher than that in ABU group,with statistical significance(all P<0.05).There was statistical significance in the degree of hydronephrosis between two groups(P<0.05).All patients in the UTI group received anti-infection treatment,with 14 cured,9 improved,and 2 not cured;50 patients in the ABU group received anti-infection treatment,with 41 cured,6 improved,and 3 not cured,with a statistically significant difference(P<0.05).The ROC curve indicated that the cut-off value of microscopic WBC was 21.5/μL,which could be used as the critical point to distinguish UTI from ABU(AUC=0.743,95%CI:0.657-0.829).Conclusion Compared with ABU patients,UTI patients are more likely to have recurrent UTIs,higher intermittent catheterization rates,higher urine routine WBC,more severe hydronephrosis,and worse prognosis after treatment of infection.Microscopic WBC≥21.5/μL can effectively distinguish UTI from ABU.
作者
陈世凯
郭婷婷
李墨农
宋兆录
彭传真
张玉海
CHEN Shikai;GUO Tingting;LI Monong;SONG Zhaolu;PENG Chuanzhen;ZHANG Yuhai(Department of Pediatric Surgery,Weifang Maternal and Child Health Hospital,Weifang 261000,China;不详)
出处
《浙江医学》
2025年第5期512-516,523,共6页
Zhejiang Medical Journal
基金
山东省医药卫生科技项目(202303070917)。
关键词
神经源性膀胱
无症状菌尿
尿路感染
临床特征
Neurogenic urinary bladder
Asymptomatic bacteriuria
Urinary tract infection
Clinical features
