Wassewa W, Dojtschewa E, Glawtschew P
Z Gesamte Inn Med. 1979 Nov 1;34(21):suppl 290-1.
During the last 2 years we examined 186 patients with secondary and 42 patients with primary chronic pyelonephritis. In most cases the secondary pyelonephritis is the sequel of a urolithiasis, less frequently in congenital renal anomalies, adenomas of the prostatic gland and patients with superposed pyelonephritis in renal lesion on account of metabolic disturbances (diabetes, gout) or abuse of analgetics. The course of the disease as well as the results of the therapy show peculiarities in the two forms of pyelonephritis. Thus, for example, the recidivations are more frequently in the secondary pyelonephritis, in the urine culture other germs appear more frequently, and the disease shows a more rapid course. The bacterial sanation in patients with primary pyelonephritis remains stable in the course of one year, where as in the obstructive pyelonephritis (non-operated cases) in the same period all patients show recidivations. After operative treatment of the obstruction the conservative treatment leads to a bacterial sanation in about 70%. In patients with superposed pyelonephritis at first the basic disease is to be treated, i.e. the metabolic disturbances are to be compensated and at the same time an antibacterial therapy is to be performed.
在过去两年中，我们检查了186例继发性慢性肾盂肾炎患者和42例原发性慢性肾盂肾炎患者。在大多数情况下，继发性肾盂肾炎是尿路结石的后遗症，较少见于先天性肾异常、前列腺腺瘤以及因代谢紊乱（糖尿病、痛风）或滥用镇痛药而在肾脏病变基础上并发肾盂肾炎的患者。这两种形式的肾盂肾炎在疾病进程和治疗结果方面都有其特点。例如，继发性肾盂肾炎的复发更为频繁，尿培养中出现其他病菌的频率更高，且疾病进展更快。原发性肾盂肾炎患者的细菌清除在一年内保持稳定，而同期梗阻性肾盂肾炎（未手术病例）的所有患者均出现复发。梗阻性肾盂肾炎经手术治疗后，保守治疗约70%可实现细菌清除。对于并发肾盂肾炎的患者，首先要治疗基础疾病，即纠正代谢紊乱，同时进行抗菌治疗。
