C反应蛋白水平在成年患者上、下尿路感染分类中的意义
Significance of C-reactive Protein Levels in Categorizing Upper and Lower Urinary Tract Infection in Adult Patients.
作者信息
Narayan Swamy Srikanth N, Jakanur Raveendra K, Sangeetha Shubha R
机构信息
Department of Internal Medicine, MS Ramaiah Medical College, Bangalore, IND.
Department of Pathology, Dr. B.R. Ambedkar Medical College, Bangalore, IND.
出版信息
Cureus. 2022 Jun 29;14(6):e26432. doi: 10.7759/cureus.26432. eCollection 2022 Jun.
BACKGROUND
Urinary tract infections (UTIs) are one of the most commonly encountered infections in outpatients. The distinction between upper UTI and lower UTI is significant as it has therapeutic and prognostic importance. The accurate diagnosis of UTI, especially its anatomical location, is essential for administering anti-microbial therapy successfully. Plasma levels of C-reactive protein (CRP) increase 1,000-fold during bacterial infections. Elevated CRP levels are often seen in acute pyelonephritis and rarely in cystitis. Therefore, this study aimed to evaluate the diagnostic role of serum CRP in upper and lower UTI in adult patients along with correlating its role in UTI patients.
MATERIALS AND METHODS
The study included 81 patients who were >18 years old, diagnosed with UTI by microbiological culture and ultrasonography of the pelvis. Demographic data along with findings of the systemic examination, complete blood count, random blood sugar, urine analysis, and CRP levels of all patients were recorded. Data were analyzed using R Studio.3.5.3 software, and a p-value ≤ 0.05 was considered significant.
RESULTS
The prevalence of UTI was higher among females (60.49%). About 53.09% of patients exhibited upper and 46.91% exhibited lower UTI. The prevalence of was higher among cases of both upper (88.37%) and lower (65.79%) UTI. The most common final diagnosis in upper UTI patients was acute pyelonephritis (90.7%) and that in lower UTI was cystitis (65.79%). The difference in the CRP levels between the upper and lower UTI patients was significant (p=0.02). Thirty-four patients had CRP levels >100 mg/L, all exhibiting upper UTI.
CONCLUSION
About 53.09% of patients exhibited upper UTI and were diagnosed with acute pyelonephritis. A significant increase in the CRP levels in upper UTI can help determine the anatomical location and can help in targeting effective management of the infection by anti-microbial therapy.
背景
尿路感染（UTIs）是门诊最常见的感染之一。上尿路感染和下尿路感染的区分很重要，因为它具有治疗和预后意义。准确诊断UTI，尤其是其解剖位置，对于成功进行抗菌治疗至关重要。细菌感染期间，血浆C反应蛋白（CRP）水平会升高1000倍。急性肾盂肾炎中经常出现CRP水平升高，而膀胱炎中则很少见。因此，本研究旨在评估血清CRP在成年患者上、下尿路感染中的诊断作用，并将其在UTI患者中的作用进行关联分析。
材料与方法
该研究纳入了81名年龄大于18岁的患者，这些患者通过微生物培养和骨盆超声检查诊断为UTI。记录了所有患者的人口统计学数据以及全身检查结果、全血细胞计数、随机血糖、尿液分析和CRP水平。使用R Studio 3.5.3软件进行数据分析，p值≤0.05被认为具有统计学意义。
结果
UTI在女性中的患病率更高（60.49%）。约53.09%的患者表现为上尿路感染，46.91%表现为下尿路感染。上尿路感染（88.37%）和下尿路感染（65.79%）中女性患病率均更高。上尿路感染患者最常见的最终诊断是急性肾盂肾炎（90.7%），下尿路感染患者最常见的最终诊断是膀胱炎（65.79%）。上、下尿路感染患者的CRP水平差异具有统计学意义（p = 0.02）。34名患者的CRP水平>100 mg/L，均表现为上尿路感染。
结论
约53.09%的患者表现为上尿路感染，并被诊断为急性肾盂肾炎。上尿路感染患者CRP水平的显著升高有助于确定解剖位置，并有助于通过抗菌治疗针对性地有效管理感染。
Zotero 插件