Mild dehydration: a risk factor of urinary tract infection?
Mild dehydration: a risk factor of urinary tract infection?
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DOI：
10.1038/sj.ejcn.1601902
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发表时间：
2003-12-01
影响因子：
4.7
通讯作者：
Beetz, R
中科院分区：
文献类型：
--
作者：
Beetz, R
细菌在尿路中的生长通常受到宿主因素的阻止，包括通过尿液和粘液流动的细菌清除、尿路上皮杀菌活性、尿液分泌性IgA以及分泌物中干扰细菌黏附的血型抗原。尿路细菌清除部分取决于尿流量和排尿频率。因此，假设液体摄入与尿路感染风险之间存在联系似乎是合乎逻辑的。然而，关于这个问题的实验和临床数据是相互矛盾的。关于水摄入对尿路感染易感性和病程影响的实验研究主要是在60年代和70年代进行的。尽管有许多悬而未决的问题，但在这一领域还没有持续的研究。只有少数临床研究产生了相互矛盾的结果，关于液体摄入对尿路感染风险的影响。数据之间不一致的一种解释可能是对液体摄入量的不确定性，这主要是在调查问卷中记录的。到目前为止，还没有确凿的证据表明尿路感染的易感性取决于液体的摄入。然而，足够的水合作用是重要的，并可能改善尿路感染的抗菌治疗结果。有关尿液动力学的实验和临床研究结果是专家委员会向尿路感染患者提供建议的基础，建议患者喝大量液体，经常排尿，完全排空膀胱。在尿路感染的治疗和预防中，结合宿主防御的行为决定的方面，而不是简单地增加液体摄入，是重要的。
Bacterial growth in the urinary tract is usually prevented by host factors including bacterial eradication by urinary and mucus flow, urothelial bactericidal activity, urinary secretory IgA, and blood group antigens in secretions which interfere with bacterial adherence. Bacterial eradication from the urinary tract is partially dependent on urine flow and voiding frequency. Therefore, it seems logical to postulate a connection between fluid intake and the risk of urinary tract infections (UTIs). However, experimental and clinical data on this subject are conflicting. Experimental studies concerning the effect of water intake on susceptibility and course of UTIs were predominantly performed in the 60s and 70s. Despite many open questions, there has been no continuous research in this field.Only few clinical studies producing contradictory results are available on the influence of fluid intake concerning the risk of UTI. One explanation for the inconsistency between the data might be the uncertainty about the exact amounts of fluid intake, which was mostly recorded in questionnaires. So far, there is no definitive evidence that the susceptibility for UTI is dependent on fluid intake. Nevertheless, adequate hydration is important and may improve the results of antimicrobial therapy in UTI. Results of experimental and clinical studies concerning urinary hydrodynamics are the basis for advice given by expert committees to patients with UTI to drink large volumes of fluid, void frequently, and completely empty the bladder. The combination of the behaviourally determined aspects of host defence and not simply increasing fluid intake is important in therapy and prophylaxis of UTI.