目的:本研究旨在探讨急性肾小球肾炎(AGN)患儿尿路感染(UTI)的危险因素。
方法:选取2021年1月至2022年1月在烟台山医院就诊的175例患儿(AGN86例,AGN和UTI89例)进行临床研究。比较分析了临床数据,如尿蛋白,血清蛋白,胆固醇,免疫球蛋白G(IgG),免疫球蛋白M(IgM),免疫球蛋白A(IgA),低密度脂蛋白(LDL),高密度脂蛋白(HDL)和脂蛋白(a)(Lp(a)),采用logistic回归分析筛选出AGN合并UTI的独立危险因素。
结果:单因素分析表明UTI与性别无关,使用血管紧张素转换酶抑制剂,胆固醇,HDL,IgM和免疫球蛋白A(p>0.05),但与年龄有关,多巴胺的剂量,尿蛋白,血清蛋白,LDL,IgG和Lp(a)(p<0.05)。多因素logistic回归分析显示,年龄,多巴胺剂量≥3µg/kg/min,尿蛋白,血清蛋白,LDL,IgG和Lp(a)是AGN患儿尿路感染的独立危险因素。
结论:年龄,多巴胺的剂量,尿蛋白,血清蛋白,LDL,IgG和Lp(a)与UTI的发生发展相关。在年幼儿童中使用大剂量多巴胺可能导致尿蛋白水平升高,LDL和Lp(a),导致血清蛋白和IgG水平较低的AGN患者发生UTI的风险较高。因此,应该注意这些病人,临床应及时采取干预措施。
OBJECTIVE: This study aimed to explore the risk factors of urinary tract infection (UTI) in acute glomerulonephritis (AGN) children.
METHODS: It selected 175 children (86 cases with AGN and 89 cases with AGN and UTI) in Yantai Mountain Hospital from January 2021 to January 2022 for clinical research, comparatively analysed the clinical data, such as urine protein, serum protein, cholesterol, immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and lipoprotein (a) (Lp (a)), and used logistic regression analysis to screen out the independent risk factors of AGN with UTI.
RESULTS: The univariate analysis showed that UTI was not related to gender, use of angiotensin converting enzyme inhibitor, cholesterol, HDL, IgM and immunoglobulin A (p > 0.05) but related to age, dosage of dopamine, urine protein, serum protein, LDL, IgG and Lp (a) (p < 0.05). The multivariate logistic regression analysis indicated that age, dosage of dopamine ≥3 µg/kg/min, urine protein, serum protein, LDL, IgG and Lp (a) were independent risk factors of UTI in AGN children.
CONCLUSIONS: Age, dosage of dopamine, urine protein, serum protein, LDL, IgG and Lp (a) were correlated with the occurrence and development of UTI. The use of high-dose dopamine in younger children could lead to higher levels of urinary protein, LDL and Lp (a), resulting in a higher risk of UTI in AGN patients with lower levels of serum protein and IgG. Therefore, attention should be paid to such patients, and intervention measures should be taken promptly in clinic.