泌尿系统超声筛查发现无症状小儿肾结石随访研究.DOC

泌尿系统超声筛查发现的无症状肾结石小儿随访分析 王志铁1 ,阳海平1 ,李秋1 ,吴道奇1 ,王荞2(400014 重庆，重庆医科大学附属儿童医院：肾脏免疫科1，超声科2) [摘要] 目的 评估无症状肾结石小儿的预以我院泌尿系统超声筛查75例无症状肾结石小儿为研究对象，其中三聚氰胺相关肾结石37例为研究组，非三聚氰胺肾结石38例为对照组平均随访41月，随访其泌尿系统超声、尿常规和尿微量蛋白。结果随访患儿50例，29例结石自发排出（58.00%）婴幼儿直径5mm结石自发排出率（76.47%78.57%）高于直径10mm组（18.75%15.38%）（P＜0.01P＜0.05）。研究组尿常规异常检出率（14.29%）与对照组（27.27%）无统计学差异（P＞0.05）。持续存在结石小儿尿常规异常检出率（38.46%）高于已排石组（5.26%）（P＜0.05无症状小儿肾结石特别是婴幼儿、直径≤5mm肾结石自发排出率较高，预后良好三聚氰胺相关肾结石预后与非三聚氰胺肾结石相似结石持续存在是无症状肾结石小儿尿检异常的危险因素，其远期预后需继续随访。 小儿；无症状；肾结石；随访；预后Outcomes of follow-up children with asymptomatic renal calculi identified by ultrasound of urinary system screening Wang Zhitie1，Yang Haiping1，Li Qiu1，Wu Daoqi1，Wang Qiao2of Renal Immunology ，2Ultrasonography，Children’s Hospital，Chongqing Medical University，Chongqing，400014，China） [Abstract] Objective To evaluate the prognosis of asymptomatic children with renal calculi. Methods 75 asymptomatic renal stones patients were followed-up for average forty-one months after diagnosis，which included 37 melamine-associated renal calculi and 38 other stones .Urinary system ultrasound，urinalysis and urinary microprotein profiles [microalbumin（Alb），immunoglobulin G(IgG)，β2-microprotein（β2-MG）and Tamm-Horsfall protein（THP）] were examined at the end of follow-up．Resultschildren（58.00%）.Infants and not more than 5 mm in diameter were discharge spontane- ously significantly higher than over three years old and larger than 10mm group（76.47%vs 18.75%、P＜0.01、P＜0.05abnormality percentage was no significant difference(P0.05). The detection rate of abnormal urinalysis in children with persistent stones was significantly higher than those who passed their stones（38.46%vs 5.26%，P＜0.05）. Urinary microprotein profiles revealed glomerular and renal tubular injury and the abnormal rates were 28.57% and 14.29% respectively. Conclusion Most asymptomatic children with renal calculi passes spontaneously especially infants and not more than 5 mm in diameter at the end of follow-up. The prognosis of childr