Sobel J D
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan.
Infect Dis Clin North Am. 1987 Dec;1(4):751-72.
Host defenses in the urinary tract constitute a highly complex and efficient system of physical, chemical, genetic, and immunologic measures aimed at limiting the presence of bacteria in the urinary tract. These mechanisms vary in their roles at different anatomical levels and are directed at eliminating bacteria and preventing their ascent to the upper tract. A detailed description is provided of anticolonization and antiadherence mechanisms that may fail for a variety of congenital and acquired reasons. Major defects in host defenses such as obstruction, stasis, calculi, and diabetes are discussed together with the pathogenesis of urinary tract infection in adults with radiologically normal urinary tracts.
尿路中的宿主防御构成了一个高度复杂且高效的系统，该系统由物理、化学、遗传和免疫措施组成，旨在限制尿路中细菌的存在。这些机制在不同解剖水平上发挥的作用各不相同，其目的是清除细菌并防止细菌上行至尿路的上半部分。文中详细描述了抗定植和抗黏附机制，这些机制可能因各种先天性和后天性原因而失效。还讨论了宿主防御方面的主要缺陷，如梗阻、淤滞、结石和糖尿病，以及尿路影像学检查正常的成年人尿路感染的发病机制。
