恶性肿瘤患者尿路感染病原菌分布及血糖和尿液分析指标联合检测的应用

doi:10.3969/j.issn.1004-583X.2026.05.003

摘要/Abstract

摘要：

目的探讨恶性肿瘤患者尿路感染(UTI)的病原菌分布特征,并评估尿液分析指标与空腹血糖联合检测在该人群中的UTI诊断价值,为临床早期诊断提供参考依据。方法选取2024年1月-2025年6月复旦大学附属肿瘤医院确诊为恶性肿瘤的住院患者,其中尿培养阳性者(阳性组)264例,尿培养阴性者(对照组)273例。检测所有受试者的尿液分析指标亚硝酸盐(NIT)、白细胞酯酶(LEU)、尿液白细胞计数(UWBC)、尿糖及空腹血糖水平,采用受试者工作特征曲线分析各指标及联合模型对UTI的诊断效能。结果阳性组共检出病原菌265株,革兰阴性菌占75.85%,革兰阳性菌占24.15%。阳性组的NIT、LEU、尿糖阳性率、UWBC和血糖水平均显著高于对照组(P<0.05)。受试者工作特征曲线分析显示,NIT、LEU、UWBC、血糖单项诊断UTI的曲线下面积分别为0.637、0.700、0.733、0.655;4项指标联合检测的曲线下面积为0.805,敏感度和特异度分别为75.00%和77.29%。结论在恶性肿瘤患者中,尿液分析指标(NIT、LEU、UWBC)与空腹血糖联合检测对UTI具有较好的辅助诊断价值,其诊断效能优于单项指标,可在尿培养结果回报前为临床早期风险评估与抗感染决策提供参考。

关键词: 肿瘤, 尿路感染, 病原菌分布, 尿液分析, 血糖

Abstract:

Objective To investigate the distribution of uropathogens in patients with urinary tract infection (UTI) and malignant tumors, and to evaluate the diagnostic value of combined urinalysis indices and fasting blood glucose for UTI in this population, providing a reference for early clinical diagnosis. Methods Hospitalized patients with malignant tumors admitted to Fudan University Shanghai Cancer Center from January 2024 to June 2025 were included. Among them, 264 patients with positive urine cultures were assigned to the positive group, and 273 patients with negative urine cultures were assigned to the control group. Urinalysis indices, including nitrite (NIT), leukocyte esterase (LEU), urine white blood cell count (UWBC), urine glucose, and fasting blood glucose, were measured in all participants. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of each indicator and their combined model for UTI. Results A total of 265 pathogens were isolated from the positive group. Gram-negative bacteria accounted for 75.85%, and Gram-positive bacteria accounted for 24.15%. The positive rates of NIT, LEU, urine glucose, UWBC, and the blood glucose level were significantly higher in the positive group than in the control group (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for NIT, LEU, UWBC, and blood glucose in the diagnosis of UTI was 0.637, 0.700, 0.733, and 0.655, respectively. The AUC for the combined detection of these 4 indicators was 0.805, with a sensitivity of 75.00% and a specificity of 77.29%. Conclusion In patients with malignant tumors, the combined detection of urinalysis indices (NIT, LEU, UWBC) and fasting blood glucose has good auxiliary diagnostic value for UTI. Its diagnostic performance is superior to that of individual indicators and may provide a useful reference for early risk assessment and anti-infective decision-making before urine culture results become available.

Key words: neoplasms, urinary tract infection, pathogenic bacteria distribution, urine analysis, blood glucose

中图分类号:

R739.9

施少鑫, 陈雪婷, 庄亦晖, 郭林, 卢仁泉, 许晓峰. 恶性肿瘤患者尿路感染病原菌分布及血糖和尿液分析指标联合检测的应用[J]. 临床荟萃, 2026, 41(5): 406-410.

Shi Shaoxin, Chen Xueting, Zhuang Yihui, Guo Lin, Lu Renquan, Xu Xiaofeng. Distribution of uropathogens in patients with malignant tumors and the application of combined blood glucose and urinalysis testing[J]. Clinical Focus, 2026, 41(5): 406-410.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.05.003

https://www.lchc.cn/CN/Y2026/V41/I5/406

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参考文献 26

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细菌名称	菌株数(株)	百分比(%)
大肠埃希菌	142	53.58
粪肠球菌	39	14.72
屎肠球菌	13	4.91
奇异变形杆菌	12	4.53
肺炎克雷伯菌	10	3.77
阴沟肠杆菌阴沟亚种	7	2.64
无乳链球菌	5	1.89
不动杆菌属	4	1.51
铜绿假单胞菌	4	1.51
普通变形杆菌	4	1.51
其他	25	9.43
总计	265	100.00

细菌名称	菌株数(株)	百分比(%)
大肠埃希菌	142	53.58
粪肠球菌	39	14.72
屎肠球菌	13	4.91
奇异变形杆菌	12	4.53
肺炎克雷伯菌	10	3.77
阴沟肠杆菌阴沟亚种	7	2.64
无乳链球菌	5	1.89
不动杆菌属	4	1.51
铜绿假单胞菌	4	1.51
普通变形杆菌	4	1.51
其他	25	9.43
总计	265	100.00

组别	例数	NIT(阴性/阳性)	LEU(阴性/阳性)	尿糖(阴性/阳性)	UWBC(个/μL)	血糖(mmol/L)
阳性组	264	185/79	92/172	225/39	129.70(17.83,780.50)	5.88(5.12,7.45)
对照组	273	266/7	179/94	261/12	12.90(2.80,58.40)	5.29(4.91,5.78)
χ²/Z值		75.293	50.473	16.815	9.350	6.223
P值		<0.001	<0.01	<0.01	<0.01	<0.01

组别	例数	NIT(阴性/阳性)	LEU(阴性/阳性)	尿糖(阴性/阳性)	UWBC(个/μL)	血糖(mmol/L)
阳性组	264	185/79	92/172	225/39	129.70(17.83,780.50)	5.88(5.12,7.45)
对照组	273	266/7	179/94	261/12	12.90(2.80,58.40)	5.29(4.91,5.78)
χ²/Z值		75.293	50.473	16.815	9.350	6.223
P值		<0.001	<0.01	<0.01	<0.01	<0.01

项目	AUC	敏感度(%)	特异度(%)	标准误	95%CI
NIT	0.637	29.92	97.44	0.024	0.590~0.684
LEU	0.700	53.41	83.88	0.023	0.656~0.745
UWBC	0.733	67.05	73.26	0.022	0.691~0.775
血糖	0.655	48.48	81.32	0.024	0.609~0.702
联合检测	0.805	75.00	77.29	0.019	0.767~0.842