Ghiringhelli L, Lepore G, Mattaini R, Caronno E, Caretta E
Minerva Med. 1981 May 7;72(18):1131-8.
All those clinical, laboratory, radiological and radioisotopic elements of importance in the diagnosis of chronic pyelonephritis in internal medicine have been examined. Anamnestic indications of chronic pyelonephritis include previous infections episodes of the urinary ways, pain in the lumbar and suprapubic region and micturition disturbances. Less significant are objective findings such as pain at percussion of the lumber region, hypertension and possible signs of renal insufficiency. Important diagnostically among laboratory examinations are leucocyturia higher than 1,000.000 in 24 hours, a findings of leucocyte cylinders, bacteriuria higher than 100.000 per cc of urine and the observation of immunoantibodies covering bacteria isolated from the urine. X-ray and radioisotopic examinations are recognised as having considerable diagnostic usefulness. None of the clinical, laboratory, X-ray or radioisotopic findings is, however, strictly specific. Confirmation of a diagnostic suspicion is only possible when scrupulous accumulation of the most typical subjective and objective findings regarding the disease is accompanied by the positivity of diagnostic tests. The results of these tests must in all cases be assessed critically in the context of the clinical picture for, taken singly, they have no decisive value.
对内科慢性肾盂肾炎诊断中所有重要的临床、实验室、放射学及放射性同位素检查项目都进行了研究。慢性肾盂肾炎的既往史指征包括既往泌尿系统感染发作、腰区及耻骨上区疼痛和排尿障碍。诸如腰区叩击痛、高血压及可能的肾功能不全体征等客观表现则不太重要。在实验室检查中，重要的诊断依据是24小时白细胞尿超过1000000、发现白细胞管型、每立方厘米尿液细菌尿超过100000以及观察到覆盖从尿液中分离出细菌的免疫抗体。X线和放射性同位素检查被认为具有相当大的诊断价值。然而，临床、实验室、X线或放射性同位素检查结果均无严格的特异性。只有当对该病最典型的主观和客观表现进行细致积累，并伴有诊断试验阳性时，才能确诊可疑诊断。在所有情况下，这些检查结果都必须结合临床表现进行严格评估，因为单独来看，它们没有决定性价值。
