陈锶琦 周参新

[摘要] 尿路感染（UTI）是一种多由单一细菌侵入尿路上皮所致的临床常见疾病，可伴有尿频尿急，也可表现为无症状性菌尿和（或）脓尿等。成年男女发病比率约为1：9。有报道称至少20%女性曾患UTI，尤其在性生活活跃期及绝经后多见。近年来由于导管技术日渐成熟，患病人群分布逐渐呈现年轻化态势。目前诊断尿路感染金标准仍然是清洁中段尿培养，但因培养周期问题往往导致结果滞后于诊疗。所以，探索出一系列兼具诊断敏感性和特异性的生物标志物格外重要。本文就“New biomarker”“UTI”为关键词搜索Pubmed及中国知网近10年相关文献，评价了以下几种有前景的新型标志物。

[关键词] 尿路感染;生物标志物;尿液;血液;磁共振成像

[中图分类号] R691.3          [文献标识码] A          [文章编号] 1673-9701（2021）35-0187-06

Clinical applications and prospects in new markers of urinary tract infection

CHEN Siqi1，2   ZHOU Canxin1，2

1.Ningbo University School of Medicine，Ningbo  315211，China;2.Nephrology Department， the Affiliated People′s Hospital of Ningbo University，Ningbo   315040，China

[Abstract] Urinary tract infection（UTI） is a common clinical disease caused by the invasion of a single bacterium into the epithelium of the urinary tract，accompanied by urinary frequency and urgency，or asymptomatic bacteriuria and/or pyuria. The incidence ratio of adult male to female is approximately 1：9. It has been reported that at least 20% of women have had UTIs，especially during the sexually active period and after menopause. In recent years，the distribution of the affected population is gradually becoming younger due to the increasing maturity of catheterization technology. The gold standard for the diagnosis of urinary tract infection is still midstream clean-catch urine culture，but the culture cycle issues often cause results to lag behind the treatment. Therefore，it is particularly important to explore a series of biomarkers with both diagnostic sensitivity and specificity. In this paper，relevant literatures in PubMed and CNKI in the past 10 years for“new biomarker”and“UTI”as key words are searched，and the following promising new markers are evaluated.

[Key words] Urinary tract infection;Biomarker;Urine;Blood;Magnetic resonance imaging

尿路感染（Urinary tract infection，UTI）是一种临床常见疾病，尤其在长期卧床、留置导尿管及泌尿道器械操作后人群中高发，其发病率与年龄、性别密切相关。有数据表明，膀胱炎发病率约为5例/1000人，患者多因膀胱刺激症状就诊，也可表现为无症状性菌尿和（或）脓尿等。目前诊断尿路感染金标准[1]是清洁中段尿培养，但周期长且费时的缺点限制其使用。所以，探索出一系列兼具诊断敏感性和特异性的生物标志物格外重要，研究表明降钙素原联合C-反应蛋白作为诊断尿路感染的价值不低于传统金标准，但在鉴别上、下尿路感染及提示致病菌种类等方面其应用价值有限。本文就以下几种有前景的新型尿路感染标志物进行评价。……