尿路结石梗阻致化脓性肾盂肾炎患者不良临床结局的相关因素分析

The Aanalysis of relatedinfluencing factors forof clinical outcome after treatment ofin patients with suppurative pyelonephritis caused by urinary tract obstructioncalculi in our hospital

摘要:

目的 探究尿路结石梗阻致化脓性肾盂肾炎患者治疗后临床结局差的相关因素。方法 选取2018年 1月—2018年12月于慈溪市中医院泌尿外科接受治疗的84例尿路结石梗阻致化脓性肾盂肾炎患者作为研究对象。 将肾功能恢复患者作为对照组，肾功能损害患者作为观察组。比较两组患者年龄、病程、平均动脉压（MAP）、 血清降钙素原（PCT）、C反应蛋白（CRP）、糖尿病患病率及尿路感染的发病率，继而行多因素Logisitic回归分 析。结果 观察组年龄、病程、血清PCT、CRP、糖尿病患病率及尿路感染发病率高于对照组（P <0.05），MAP低 于对照组（P <0.05）。多因素Logisitic回归结果显示：高PCT［O＾R=3.522（95% CI：1.220，10.168），P <0.05］、 高CRP［O＾R=1.993，（95% CI：1.022，3.887），P <0.05］、有糖尿病［O＾R=2.942（95% CI：1.302，6.648），P < 0.05］及尿路感染［O＾R=2.083（95%CI：1.325，3.275），P <0.05］是尿路结石梗阻致化脓性肾盂肾炎患者临床结 局差的影响因素，高MAP［O＾R=0.642（95% CI：0.490，0.840），P <0.05］为其保护因素。结论 年龄、病程、 MAP、PCT、CRP、糖尿病及尿路感染是尿路结石梗阻致化脓性肾盂肾炎患者临床结局差的影响因素，临床应该 加以重视，改善不良临床结局。

Abstract:

Objective To explore the influencing factors for clinical outcome in suppurative pyelonephritis caused by urinary calculi. Methods Eighty-four patients with suppurative pyelonephritis caused by urinary calculi treated in our hospital from January 2018 to December 2018 were selected. According to the clinical outcome, all patients were divided into two groups. The renal function was recovered in control group, while that in the observation group was compromised after treatment. The age, course of disease, mean arterial pressure (MAP), serum procalcitonin (PCT), C-reactive protein (CRP), number of diabetic patients, and incidence of urinary tract infection were compared between the two groups. The multivariate Logistic regression analysis was further performed to investigate the risk factors for poor clinical outcome in suppurative pyelonephritis caused by urinary calculi. Results The age, course of disease, levels of serum PCT and CRP, and incidence of diabetes mellitus and urinary tract infection were higher in the observation group than those in the control group (P < 0.05), while MAP in the observation group was lower than that in the control group (P < 0.05). The multivariate Logistic regression showed high levels of serum PCT [O^R = 3.522 (95% CI: 1.220, 10.168)] and CRP [O^R = 1.993 (95% CI: 1.022, 3.887)], as well as occurrence of diabetes mellitus [O^R = 2.942 (95% CI: 1.302, 6.648)] and urinary tract infection [O^R = 2.083 (95% CI: 1.325, 3.275)] were negative factors affecting the clinical outcome. However, high MAP [O^R = 0.642 (95% CI: 0.490, 0.840)] was a protective factor for the clinical outcome. Conclusions The age, course of disease, MAP, serum PCT and CRP, diabetes mellitus, and urinary tract infection are important factors affecting the clinical outcome in suppurative pyelonephritis caused by urinary calculi, and should be emphasized in clinical practice.