小儿单纯性血尿分析及随访  

Isolated hematuria in children:analysis and follow-up survey

作　　者：樊志荣[1] 林彦伟 

机构地区：[1]上海市松江区中心医院,上海201600 [2]包头钢铁公司职工医院,包头014010

出　　处：《武警医学院学报》2002年第1期31-33,共3页Acta Academiae Medicinae CPAPF

摘　　要：目的 :评价单纯性血尿的临床意义和常用检查方法在单纯性血尿诊断中的价值。方法 :对 72例单纯性血尿患儿进行血常规、补体、尿红细胞形态、尿钙、尿肌酐等系列检查并随访 1～ 8年。结果 :经系列检查病因诊断 1 1例随访期合并轻度蛋白尿 4例、肾病综合征 1例。符合急性肾炎 2例、运动性血尿 2例。肾活检 4例 ,轻度系膜增生 2例、狼疮性肾炎和IgA肾病各 1例。随访期结束 ,血尿消失 58例 ,占 81 %。无高血压或肾功能不全。结论 :单纯性血尿既可以是一些疾病的早期表现又可自然消失。大多数单纯性血尿表现为自然消失的良性过程。尿钙、尿肌酐、尿培养、血补体和B超检查的诊断价值较高 ,应列为常规检查。肾活检在指导治疗和预后方面具有较大的局限性 ,应慎重选用。Objective:The purpose was to determine the clinical significance of isolated hematuria and the value of laboratory test in diagnosis.Methods:72 children of isolated hematuria,aged 3 mo to 14yr,were studied by a series of laboratory tests and then followed up for 1 8yr.Result:Of 72 patients,etiological diagnosis were made by the series of laboratory tests in 11 patients.During the follow up peroid,4 mild proteinturia were found in 4 cases,nephrotic syndrom in 1,acute glomerulonephritis in 2 and sports hematuria in 2.4 children received renal biopsy for recurrent gross hematuria or proteinturia,1 was lupus glomerulonephritis,1 was Ig A nephropathy and 2 were mesangial proliferative glomerulonephritis.At the end of the follow up peroid,of 72 patients,58 were free from hematuria.Conclusion:Our data demonstrate that isolated hematuria is a manifestation of some diseases as well as disappear naturely.However,isolated hematuria is a begin finding in majority of children.Urine calcium,urine culture,serum complement concentration and renal ultrasound are more useful in diagnosis.Renal biopsy is not indicated for its limited value in treatment and prognosis.Follow up survey is a wise stratgy in treatment of isolated hematuria.

关 键 词：单纯性血尿 诊断 预后 小儿 肾活检 

分 类 号：R726.958[医药卫生—儿科]