Watts G F, O'Brien S F, Shaw K M
Department of Medicine, University of Western Australia, Royal Perth Hospital, Australia.
Diabet Med. 1996 Jun;13(6):520-4. doi: 10.1002/(SICI)1096-9136(199606)13:6<520::AID-DIA128>3.0.CO;2-D.
The frequency of urinary infection was determined using quantitative microbiology in 172 insulin-dependent diabetic patients repeatedly being tested for microalbuminuria over 18 months on at least six occasions. The point prevalence of urinary infection at first screening for microalbuminuria was 3%. Over the period of study, 20 of the patients (12%) showed evidence of urinary infection, defined as a pure growth of a recognized pathogen > 10(7)I-1. Infection was more common in women than men (20% vs 5%, p < 0.01) and was significantly associated with the presence of peripheral neuropathy (p < 0.05). Infection was not related to patient age, duration of diabetes, glycaemia, blood pressure, retinopathy or autonomic neuropathy. There were no significant within-patient differences in albumin excretion, glycaemic control or blood pressure in relation to the presence and absence of urinary infection. In only one patient (5%) did urinary infection significantly increase the urinary albumin excretion and this was associated with pyuria. We conclude that the presence of urinary infection does not apparently affect the measurement of urinary albumin excretion unless pyuria is present. Unless diabetic patients are symptomatic, examination of the urine for infection is probably unwarranted when testing for microalbuminuria.
对172例胰岛素依赖型糖尿病患者进行了为期18个月的研究，这些患者至少接受了6次微量白蛋白尿检测，采用定量微生物学方法确定尿路感染的发生率。首次筛查微量白蛋白尿时尿路感染的时点患病率为3%。在研究期间，20例患者（12%）有尿路感染的证据，定义为单一培养出的已知病原体>10(7)/L。女性感染比男性更常见（20%对5%，p<0.01），并且与周围神经病变显著相关（p<0.05）。感染与患者年龄、糖尿病病程、血糖、血压、视网膜病变或自主神经病变无关。无论有无尿路感染，患者在白蛋白排泄、血糖控制或血压方面均无显著差异。仅1例患者（5%）尿路感染显著增加了尿白蛋白排泄，且与脓尿有关。我们得出结论，除非存在脓尿，否则尿路感染的存在显然不会影响尿白蛋白排泄的测量。除非糖尿病患者有症状，否则在检测微量白蛋白尿时，对尿液进行感染检查可能没有必要。
