Wu T T, Lee Y H, Tzeng W S, Chen W C, Yu C C, Huang J K
Department of Surgery (Urology), Veterans General Hospital-Kaohsiung, Taiwan, Republic of China.
J Urol. 1994 Jul;152(1):26-8. doi: 10.1016/s0022-5347(17)32807-0.
Serum C-reactive protein levels and erythrocyte sedimentation rates were prospectively evaluated in 38 patients with dilated pyelocaliceal systems in an attempt to distinguish simple hydronephrosis from infected hydronephrosis and pyonephrosis. The clinical presentations of infected hydronephrosis and pyonephrosis were extremely variable, ranging from no constitutional complaints to urosepsis. Renal sonography detected only 6 of 16 patients with pyonephrosis (specificity 96%, sensitivity 38%, accuracy 72.5%). Using a cutoff value of 3.0 mg./dl. for C-reactive protein and 100 mm. per hour for erythrocyte sedimentation rate, the diagnostic accuracy of detecting infected hydronephrosis and pyonephrosis increased to 97%, with a specificity of 89% and sensitivity of 100%. Based on our experience, we believe that the serum C-reactive protein and erythrocyte sedimentation rate levels can be used as screening tests to distinguish pyonephrosis and infected hydronephrosis from simple, uncomplicated hydronephrosis.
对38例肾盂肾盏扩张系统患者的血清C反应蛋白水平和红细胞沉降率进行了前瞻性评估，以试图区分单纯肾积水与感染性肾积水及肾积脓。感染性肾积水和肾积脓的临床表现极为多样，从无全身不适主诉到出现尿脓毒症。肾脏超声检查仅在16例肾积脓患者中检测出6例（特异性96%，敏感性38%，准确性72.5%）。以C反应蛋白3.0mg/dl及红细胞沉降率每小时100mm为临界值，检测感染性肾积水和肾积脓的诊断准确性提高到97%，特异性为89%，敏感性为100%。根据我们的经验，我们认为血清C反应蛋白和红细胞沉降率水平可作为筛查试验，以区分肾积脓和感染性肾积水与单纯的、无并发症的肾积水。
