紫色尿袋症候群－4年內7位老年住院病例之觀察

Purple Urine Bag Syndrome-An Observation of 7 Geriatric Medical Cases in 4 Years

郭緒東(Hsu-Tung Kuo) ； 湯榮興(Jung-Hsing Tung) ； 張天長(Tien-Chang Chang)

《內科學誌》 21卷2期 (2010/04) Pp. 155-161

https://doi.org/10.6314/JIMT.2010.21(2).10

摘要

紫色尿袋症候群的機轉，咸認爲是尿液中的靛紅質和靛青質的生化反應，大多發生在長期照護中心或居家安養的老年患者。本文以回溯方式收集本院住院病例，共4年內曾發現紫色尿袋症候群現象的患者，總計12位收案病人，包括11位女性(91.7%)及1位男性(8.3%)。在排除合併其他部位感染者5人後，剩下的7人納入研究之中。再依症狀性泌尿道感染的標準分類，其中3位爲無感染症狀的「單純紫色尿袋症候群」，剩下的4位依照是否曾經接受抗生素的治療，有2位爲使用抗生素的「治療組」，和2位未使用抗生素的「非治療組」，共3大類組做爲研究比對。對於符合症狀性泌尿道感染標準的「非治療組」，未使用抗生素是依當時醫師的判斷，以治療主訴相關疾病爲主。分析3位單純紫色尿袋症候群的病例，平均腋溫爲36.8℃，平均尿液酸鹼pH值爲8.0，平均住院日數爲4.67天。分析「治療組」，平均腋溫爲38.0℃，平均尿液酸鹼pH值爲5.5，平均住院日數爲7天，皆有意識功能的改變。分析「非治療組」，平均腋溫爲38.4℃，平均尿液酸鹼pH值爲8.5，平均住院日數爲9天。本文建議有紫色尿袋症候群現象的患者，若符合症狀性泌尿道感染，應使用抗生素治療，並且若有意識功能改變或是呈現酸性尿的患者，可能代表著較嚴重的病況，建議能進一步住院使用抗生素治療。若是單純紫色尿袋症候群，則以處理其危險因子，加強泌尿道照護及留心觀察即可。

關鍵字

紫色尿袋症候群 ； 色胺酸 ； 症狀性泌尿道感染

並列摘要

Purple urine bag syndrome is considered to be caused by a biochemical mechanism involving indirubin and indigo in the urine; it occurs among geriatric patients who are living in long-term care centers or under home care. This study retrospectively analyzed purple urine bag phenomenon patients over four years. There were twelve patients, made up of eleven females and one male, and samples were collected from each of these. Five patients were excluded due to another infection process leaving seven patients. Using the standard criteria for symptomatic urinary tract infection, we classified these individuals into three groups. These were, firstly, simple purple urine bag syndrome (3 cases), secondly, those being treated with antibiotics (2 cases) and thirdly, a nontherapy group that was not undergoing antibiotics treatment (2 cases). Antibiotics therapy was defined based on the chart of the attending doctors. The simple purple urine bag syndrome group patients had a mean axillary temperature of 36.8℃, a mean urine pH of 8.0 and a mean length of hospital stay of 4.67 days. The equivalent information for the therapy group was 38.0℃, pH 5.5 and 7 days, respectively. Similarly, for the non-therapy group the values were 38.4℃, pH 8.5 and 9 days, respectively. Based on a symptomatic urinary tract infection and purple urine bag syndrome, patients showing either disturbance in their level of consciousness or acidic urine should be admitted and antibiotic therapy started. Individuals with simple purple urine bag syndrome should be observed carefully and particular care taken with their urinary tract hygiene.

並列關鍵字

Purple urine bag syndrome ； Tryptophan ； Symptomatic urinary tract infection