Analysis Of Clinical Features And Biological Markers Of Children With Urinary Tract Infection

Objective:To explore the the differences of clinical features and biological markers level between upper urinary tract infection (UUTI) children,lower urinary tract infection (LUTI) children and patients with vesicoureteral reflux(VUR), for the better realization of UUTI and VUR.Methods:219children with urinary tract infection (UTI) hospitalized in our hospital from May2010to September2012were devided into UUTI group and LUTI group,VUR group and no VUR group.The clinical information (sex,age,oneset systems),laboratory test including blood urea and creatinine,biological markers including serum CysC,β2-MG,urine mAlb, TF,a1-M, B2-MG, NAGand imagine examinations (doppler ultrasonic, Renal computer tomography enhancement scan,Intravenous pyelogram,MCU)were recorded.Receiver operator characteristic (ROC) curve was used to analysis the data.Result:1. The clinical characteristics of UTI in children①0～3years is the high-risk stage,they accounting for59.4%of the total number of children with UTI.②The number of girls is more than boys. Along with the growth of age,the number of them all decreaseThe number of boy declined obviously after3years.③Urinary irritation,macroscopic hematuria,fever are the most common onset symptoms of UTI. Along with the growth of decline,the symptoms of them are more nonspecific.④Another,8.7%without clinical symptoms of urinary system, only for heating with abnormal urine test or imaging anomaly.Their average age is0.9years, which is less than the other patients (P<0.05)2. Compare the differences of clinical features and biological markers level between UUTI and LUTI children.①The age of UUTI group is(1.920±0.968years), which is less than LUTI group (P<0.05).②Gender percentage between the two groups is no difference (P>0.05).③Fever is the most performance of UUTI group,more of them are associated with waist pain or abdominal discomfort,cloudy urine, nausea and vomiting,developmental delay. LUTI group present naked eye hematuria, urinary irritation symptoms.④Serum CysC, PCT, urinary NAG, B2-MG, mAlb, a1-MG and TF has certain clinical value for the diagnosis of UUTI joint detection of NAG, CysC, PCT has good clinical value to positioning diagnosis UTI. 3. Comparison of clinical characteristics, biological markers level between VUR and not merge VUR groups.①Onset age of VUR group was (1.222±1.029) years, which is significantly less than not merge VUR group (3.530±2.847) years.②Merge VUR group UUTI incidence is higher than not merge VUR group,(P<0.05).③The incidence of recurrent UTI was significantly higher than merge VUR group,(P<0.01).④The biological markers (including:serum BUN, Cr, CysC, PCT, urinary NAG, mAlb,β2-MG, a1-MG and TF) to identify whether the merger withVUR is nonsense,(P<0.05).4.ROC curve analysis diagnostic value of meaningful indicators①By age discrimination UUTI, LUTI diagnosis accuracy is low (AUC<0.7).②Identify UUTI and LUTI with fever has serten clinical value.③Serum CysC, PCT, urinary NAG,β2-MG, mAlb,a1-MG and TF has certain clinical value for the diagnosis of UUTI (AUC>0.7) joint detection of NAG, CysC, PCT has good clinical value to positioning diagnosis UTI (AUC=0.916)④At1.2years for critical point screening merger VUR high-risk children have certain clinical value (AUC>0.7).Conclusions:1. Aged0～3years is high-risk group of UTI, the smaller of age the less significant of urinary systemsymptoms.2. The age of UUTI group is less than LUTI group, UUTI children with fever as the main performance, the clinical manifestations of LUTI group is fever, macroscopic haematuria and urinary irritation symptoms. Serum CysC, PCT, urinary NAG,β2MG, mAlb, a1-MG and TF has certain clinical valuethe of diagnosis UUTI.Combined detection of NAG, CysC, PCT has good clinical value of positioning diagnosis.3. Children whose age is less than1.2years old has more risk for merger VUR Incidence of recurrent UTI and UUTI were higher in Children merger VUR. The biological markers (including:serum BUN, Cr, CysC, PCT, urinary NAG, mAlb, β2-MG, a1-MG and TF) have nonsense to identify whether merger with VUR.