【摘要】 目的分析不同年龄泌尿道感染儿童膀胱输尿管返流(VUR)和肾瘢痕的发生情况,加强对VUR的认识,提高检出率。方法选择上海交通大学附属新华医院儿科2001年1月-2006年12月因泌尿道感染入院患儿90例,通过排泄性膀胱尿道造影(VCUG)和(或)直接放射性核素膀胱造影(DRNC)明确诊断VUR共40例。分别根据泌尿道感染发生次数及不同年龄,分为首次泌尿道感染和1次以上泌尿道感染组,>5岁和≤5岁组;分析VUR在首次泌尿道感染和1次以上泌尿道感染组、不同年龄组发病率情况。通过肾静态皮质显像(DMSA)检测肾瘢痕,分析年龄与VUR的级别、肾瘢痕的关系。剖析胎儿超声检查异常、生后VUR和肾瘢痕的发生情况。结果VUR的发病率在首次泌尿道感染和1次以上泌尿道感染组、>5岁和≤5岁组差异均有统计学意义(χ2=10.627,4.409Pa<0.05)。年龄与VUR的级别、年龄与肾瘢痕均呈负相关(r=-0.342,-0.348Pa<0.05)。反复泌尿道感染、≤5岁的泌尿道感染患儿VUR的发生率高。年龄越小发生肾疤痕和高级别VUR的可能性越大。胎儿B超检查显示肾积水患儿,发生高级别VUR和肾瘢痕的可能性大。结论反复泌尿道感染、≤5岁的泌尿道感染患儿、胎儿B超检查显示肾积水的患儿应及时行VCUG和DMSA,及时发现、监测VUR和肾瘢痕。更多还原

【Abstract】 Objective To investigate the occurrence of vesico-urethral reflux (VUR) and renal scarring among urinary tract infection in children of different ages to identify VUR sooner.Methods Ninety hospitalized children were chosen from Jan.2001 to Dec.2006,who were diagnosed as urinary tract infection.All these cases were respectively divided into 2 groups according to their ages or the frequency of urinary tract infection.Voiding cystourethrography (VCUG )and(or) direct radionuclide cystography(DRNC) were used to definitively diagnose VUR and renal cortical (DMSA )to renal scarring.The differences in occurrence of VUR were compared based on age or frequency of urinary tract infection.Correlations between the age and grades of VUR,between the age and occurrence of renal scarring were evaluated.The occurrence of VUR and renal scarring in the children detected to have hydronephrosis by prenatal ultrasound was analyzed.Results The occurrence of VUR in 2 age-based groups was significantly different(χ2=4.409 P=0.036),and that in groups based on frequency of urinary tract infection was also distinctive(χ2=10.627 P=0.001).There was a negative correlation respectively between the age and grades of VUR(r=-0.342 P=0.031),the renal scarring and age(r=-0.348 P=0.022).The children with prenatally detected VUR (hydronephrosis by prenatal ultrasound) tend to have higher grades of VUR and renal scarring.Conclusions The study has shown that VCUG and DMSA should be performed on the children with recurrent urinary tract infections,those detected hydronephrosis by prenatal ultrasound and those on or less than 5 years old of age as VUR and renal scarring can be identified earlier by VCUG and DMSA.更多还原