Higgins P M
Epidemiol Infect. 1996 Apr;116(2):193-201. doi: 10.1017/s0950268800052432.
Twenty-one patients considered to have acute poststreptococcal glumerulo-nephritis were encountered during 35 years of general practice. In ten of them good evidence of active streptococcal infection at the time of discovery of nephritis was recorded. The more complete the data the more convincing was the evidence of active infection. In over half of those whose urine were routinely cultured pathogens were isolated and over a third were treated for infection of the urinary tract. Such infections were associated with adverse effects and prolonged illness. As compared with children, adults in general had a longer history of ill-health, were less likely to present with acute infections and more likely to have urinary tract infections and prolonged illness. Vigorous antistreptococcal treatment was followed by rapid recovery in those patients so treated whose illnesses were not complicated by urinary tract infections. Concurrent streptococcal infection and secondary infection of the urinary tract may contribute more to the onset of acute poststreptococcal glomerulo-nephritis and to its course than is currently believed.
在35年的全科医疗实践中，共遇到21例被认为患有急性链球菌感染后肾小球肾炎的患者。其中10例在发现肾炎时记录有活动性链球菌感染的确切证据。数据越完整，活动性感染的证据就越有说服力。在超过一半的患者中，其尿液常规培养分离出了病原体，超过三分之一的患者接受了尿路感染治疗。此类感染与不良反应和病程延长有关。与儿童相比，成年人总体上健康状况不佳的病史更长，出现急性感染的可能性较小，更易发生尿路感染且病程延长。在那些未并发尿路感染的患者中，积极的抗链球菌治疗后病情迅速恢复。目前认为，并发的链球菌感染和泌尿系统继发感染对急性链球菌感染后肾小球肾炎的发病及其病程的影响可能比目前所认为的更大。
