CAJ | 학술논문

目的调查因三聚氰胺污染奶粉致泌尿系结石婴幼儿1年后康复情况. 方法三聚氰胺致泌尿系结石婴幼儿81例,男51例,女30例.随访时年龄13～48个月,平均26个月.对患儿进行了1年后B超复查,血BUN、SCr、尿酸含量检测,并行尿常规检查,同时检测尿液中α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、微量白蛋白(UMA)的含量.81例同年龄段未食用污染奶粉的健康婴幼儿作为对照组,行尿常规检查及尿α1 -MG、β2-MG、UMA检测. 结果内科治疗组54例,结石残留3例,直径分别为0.3、0.3、0.4 cm;外科治疗组27例,结石残留2例,直径为1.5、0.2 cm,1.5cm残留结石为阳性结石,行经皮肾镜取石治疗.患儿UMA水平明显升高,中位数(四分位间距)为5.4(8.0) mg/L,对照组为2.3(4.9) mg/L,两组比较差异有统计学意义(P＜0.0l);血BUN、SCr、尿酸均在正常范围,不同治疗组间差异无统计学意义(P＞0.05). 结论大多数三聚氰胺致婴幼儿泌尿系结石采用内科或外科治疗效果确切,结果满意,如果1年后残留结石直径＞1.0 cm建议手术治疗.
목적 조사인삼취청알오염내분치비뇨계결석영유인1년후강복정황. 방법 삼취청알치비뇨계결석영유인81례,남51례,녀30례.수방시년령13～48개월,평균26개월.대환인진행료1년후B초복사,혈BUN、SCr、뇨산함량검측,병행뇨상규검사,동시검측뇨액중α1-미구단백(α1-MG)、β2-미구단백(β2-MG)、미량백단백(UMA)적함량.81례동년령단미식용오염내분적건강영유인작위대조조,행뇨상규검사급뇨α1 -MG、β2-MG、UMA검측. 결과 내과치료조54례,결석잔류3례,직경분별위0.3、0.3、0.4 cm;외과치료조27례,결석잔류2례,직경위1.5、0.2 cm,1.5cm잔류결석위양성결석,행경피신경취석치료.환인UMA수평명현승고,중위수(사분위간거)위5.4(8.0) mg/L,대조조위2.3(4.9) mg/L,량조비교차이유통계학의의(P＜0.0l);혈BUN、SCr、뇨산균재정상범위,불동치료조간차이무통계학의의(P＞0.05). 결론 대다수삼취청알치영유인비뇨계결석채용내과혹외과치료효과학절,결과만의,여과1년후잔류결석직경＞1.0 cm건의수술치료.
Objective To investigate the condition of infants with urolithiasis caused by melaminetainted powdered formula at one-year follow-up. Methods Eighty-one young children with melamine-induced urolithiasis were followed up,which included urinalysis,renal-function tests,urinary tests for biochemical markers of renal glomerular and tubular function,and ultrasonography.Eighty-one age-matched healthy infants without exposure to melamine-contaminated formulas were enrolled as controls. Results Fifty-one of the patients were male and 30 female,with a mean age of 26 months (range 13 -48 months).The 81 children were divided into 2 groups according to treatment protocols.Group 1 received conservative treatment ( n =54 ) and Group 2 received surgical treatment ( n =27 ).In Group 1,3 patients (5.6％) had stone-residual:1 girl had calculus of 0.4 cm in diameter in the left kidney and 2 girls had calculus of 0.3 cm in diameter in the right kidney.In Group 2,2 patients (7.4％) had stone-residual,1 boy had crystallization of 0.2 cm in diameter in the right kidney and 1 boy had calculus of 1.5 cm in diameter in the left kidney,positive stone was confirmed by X-ray and accepted percutaneous nephrolithotomy.Urinary microalbumin levels were significantly increased in the children with melamine-induced urolithiasis compared with the control group (P ＜0.01 ).Blood urea nitrogen and serum creatinine were within the normal range with no significant difference between the 2 groups. Conclusions At one-year follow-up most of the children exposed to melamine-tainted infant formula in both treatment groups had returned to a healthy state,suggesting a satisfactory outcome for both treatment options.However,surgery is recommended in patients with stoneresidual ＞ 10 mm.