常染色体显性多囊肾病患者囊肿感染的处理:一项单中心研究

A. Tanaka, D. Inaguma, Yu Watanabe, Takahiro Mizukawa, Hibiki Shinjo, K. Koike, Y. Otsuka, A. Takeda
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摘要

背景与目的:常染色体显性多囊肾病(ADPKD)患者常并发囊肿感染。虽然这种并发症具有重要的临床意义,但囊肿感染的报道非常有限。在此,我们报道了ADPKD患者的囊肿感染状况来澄清这一点。材料与方法:2010 - 2017年我院收治的90例ADPKD患者中,选择诊断为囊肿感染的患者。我们回顾性地收集病历资料。结果:共纳入22例患者,其中男性12例,女性10例。6例(27.3%)患者在影像学上发现感染囊肿。细菌培养阳性12例(54.5%)。喹诺酮类、头孢菌素、碳青霉烯类和万古霉素的初始抗生素治疗分别为7例(31.8%)、11例(50%)、3例(13.6%)和3例(13.6%)。平均住院时间12.0天(9.25 ~ 14.75天),平均抗生素治疗时间26.5天(21.25 ~ 29.50天)。没有病人死亡。9例(40.9%)患者既往有囊肿感染发作,11例(50.0%)患者在研究期间复发。维持性透析患者住院时间超过中位12天的比例较高,但差异无统计学意义(80.0%比50.0%,P = 0.1453)。多元回归分析中,白蛋白值与住院时间呈负相关(β-系数:−0.4835,95%可信区间:−15.5757 ~−0.9460,P = 0.0290)。结论:营养状况不佳的ADPKD患者可能需要额外的医疗照顾,以避免长期住院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of cyst infection in patients with autosomal dominant polycystic kidney disease: A single-center study
Background and Objective: Cyst infections often develop as a complication in patients with autosomal dominant polycystic kidney disease (ADPKD). Although this complication has significant clinical implications, reports of cyst infection are extremely limited. Herein, we report on the status of cyst infection in patients with ADPKD to clarify this. Materials and Methods: Among 90 patients with ADPKD admitted to our hospital from 2010 to 2017, we selected those diagnosed with cyst infection. We collected the data from medical record retrospectively. Results: A total of 22 patients, comprising 12 men and 10 women, were included in the study. Infected cysts were identified on imaging in six (27.3%) patients. Bacterial culture was positive in 12 (54.5%) patients. The initial antibiotic treatment was quinolone, cephalosporin, carbapenem, and vancomycin in 7 (31.8%), 11 (50%), 3 (13.6%), and 3 (13.6%) patients, respectively. The mean hospitalization period was 12.0 days (range, 9.25–14.75), while the mean antibiotic treatment period was 26.5 days (range, 21.25–29.50). No patient died. Nine (40.9%) patients had previous episodes of cyst infection, and 11 (50.0%) had recurrence during the study period. The rate of prolonged hospitalization longer than the median of 12 days was higher in patients with maintenance dialysis, although the difference was not significant (80.0% vs. 50.0%, P = 0.1453). In multiple regression analysis, the albumin value showed a negative correlation with the hospitalization period (β-coefficient: −0.4835, 95% confidence interval: −15.5757–−0.9460, P = 0.0290). Conclusion: Patients with ADPKD who have a poor nutritional status may require additional medical attention to avoid prolonged hospitalization.
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