成人多囊肾病泌尿系感染与肾功能损害的相关性研究

目的　探讨成人多囊肾病 (ADPKD)泌尿系感染对肾功能损害的临床意义。方法　分析总结 478例ADPKD患者泌尿系感染发生率 ,及其与肾功能损害的相关性。结果　本组ADPKD泌尿系感染的发生率为2 6 .4%。膀胱炎 2 7例、肾盂肾炎 89例、囊肿感染积脓 11例、肾周脓肿 3例、无症状性泌尿系感染 9例。感染与性别、泌尿系统器械检查、肾功能不全及尿石症等因素有关。反复泌尿系感染是导致ADPKD肾功能进行性损害的最重要因素。结论　避免各种不必要的器械检查 ,积极消除肾内、肾外梗阻因素 ,应用有效的抗生素 ,对控制和预防ADPKD的泌尿系感染 ,延缓肾功能损害具有十分重要的意义

The detrimental effect of urinary tract infection on renal function of adults with autosomal dominant polycystic kidney disease

Objective To evaluate the clinical significance of urinary tract infection (UTI)on deterioration of renal function in patients with autosomal dominant polycystic kidney disease (ADPKD). Methods Retrospective studies were performed in 478 cases with ADPKD diagnosed and treated in our hospital from Jun.1960 to Nov.2000, emphasizing on the relationship between UTI and renal function damage. Results The incidence of urinary tract infection of ADPKD in this group was 26.4%. There were cystitis in 27 cases, pyelonephritis in 89, pyocyst in 11, perinephric abscess in 3, and asymptomatic UTI in 9 cases. The predominant factors related to UTI were gender, urological instrumental intervention, renal insufficiency and urinary stone disease. Recurrent UTI was the most important deteriorating factor of renal function of ADPKD.Conclusion Avoidance of unnecessary instrumental examination , elimination of intrarenal and extrarenal obstructive factors, use of effective and sensitive antibiotics are the crucial measures for control and prevention of UTI' and progressive deterioration of renal function in patients with ADPKD.