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1、回肠原位新膀胱患者的无症状菌尿症Bacteriuriainpatientswithanorthotopicilealneobladder:urinarytractinfectionOrasymptomaticbacteriuria?回肠原位新膀胱患者的菌尿：尿路感染还是无症狀菌尿症？FrancescaSuriano,MicheleGallucci*,GerardoPaoloFlammia,StefaniaMusco,AntonioAlcini,GregorioImbalzano?andGiordanoD
2、icuonzo?DepartmentsofUrologyand?Microbiology,CampusBio-Medico,and*ReginaElenaCancerInstitute,Rome,ItalyAcceptedforpublication14September2007OBJECTIVEToinvestigatetheprevalenceofasymptomaticbacteriuria(ABU)andurinarytractinfection(UTI),andthelocalandsyste
3、micinflammatoryresponse,inpatientswithilealneobladder.课题：对回肠新膀胱患者进行无症状菌尿症和尿路感染以及局部和系统炎症反应的普遍性调查。PATIENTSANDMETHODSThestudyincluded40patientswhohadaradicalcystectomyandilealneobladder.Twourinesamples,oneforchemicalandphysicalanalysis,andcytofluorimetry,an
4、doneforurineculture,werecollectedevery3monthsfor9monthsaftersurgery.对象与方法:对40名进行过膀胱全切的回肠新膀胱的患者进行研究。在其手术后，每隔3~9个月进行尿液采样，并分为两组，一组用于进行化学与物理分析和细胞荧光测定，另一组则进行尿培养。RESULTSOf119urinecultures,69(57%)werepositiveforbacteria.Onlynineofthe40patientshadnobacteriuriaon
5、urineculture.EscherichiaColistrainswereculturedfromeightof10patientswithpersistentlypositiveurine.Theincidenceofbacteriuriawasdifferentaccordingtogender.Therewasahighconcentrationofleukocytes(0–6μL)in118of119samples.Themeanconcentrationofleukocytesinster
6、ileurineculturewas1181/μL,whileinpatientswithABUthemeanwas491(P?0.05).（分析）结果：尿培养的119份尿样中，69份（占57%）呈阳性。40名患者中仅有4人的尿培养液中无细菌。在呈阳性的患者中，每10人中便有8人的尿液中存在大肠杆菌群。不同性别菌尿症发病率不同。119份尿样中有118份的白血球浓度极高。在无菌条件下进行的尿培养中，白血球平均浓度为1181/μL，而在菌尿症患者中平均浓度则为491(P?0.05).CONCLUSIONAp
7、ositiveurinecultureisaverycommonfindinginpatientswithanorthotopicbladder.Themostinterestingresultswastheabsenceofelevatedinflammatoryindicesand/orsymptoms,eveninthosepatientswithhighlevelsofbacteriuria.Probablythisisduetothecompletelydifferentinflammator
8、yresponseofilealmucosaagainstbacteriathanhasbladdermucosa.Indeed,theleukocyteconcentrationdetectedinurinarysedimentwasinverselyassociationwithbacterialgrowthinurinecultures.ThesefindingssuggestaredefinitionofABUandUTIinpat
