儿童无症状血尿431例病因分析及随访  

Etiological analysis of asymptomatic hematuria in 431 children and follow-up

作　　者：孙智才[1] 刘玉玲[1] 潘晓芬[1] 林国模[1] 雷辛衍[1] 

机构地区：[1]广东省中山市博爱医院儿科,广东中山528403

出　　处：《临床儿科杂志》2015年第9期810-812,共3页Journal of Clinical Pediatrics

摘　　要：目的：探讨儿童无症状血尿的病因和转归？方法回顾性分析2001年1月至2014年12月就诊的431例无症状血尿患儿的病因、临床特点及预后？结果431例患儿中，男197例、女234例，初诊年龄（5.52±2.77）岁（8个月～17岁）；持续镜下血尿425例，发作性肉眼血尿6例。肾小球源性血尿315例（73.1%），其中临床诊断为孤立性血尿286例，急性肾小球肾炎5例；病理诊断肾小球轻微病变13例，IgA肾病4例，系膜增生性肾小球肾炎4例，薄基底膜肾病3例。非肾小球源性血尿136例（31.5%），其中左肾静脉压迫综合征113例，特发性高钙尿症17例，肾结石4例，泌尿道感染1例，左肾缺如1例。286例孤立性血尿患儿随访（3.05±2.69）年（0.5～13.5年），145例（50.7%）血尿消失，其中110例在初诊后3年内消失；24例伴有血尿家族史的患儿中仅有6例血尿消失；所有孤立性血尿患儿随访结束时肾功能都维持良好？结论儿童无症状血尿发病年龄跨度大，以肾小球源性血尿居多；儿童孤立性血尿大多在初诊后3年内消失，伴有血尿家族史者血尿持续时间可能更长；儿童期孤立性血尿预后良好，需长期随访。ObjectiveTo investigate the etiology and prognosis of asymptomatic hematuria in children.MethodsThe etiological factors, clinical features and prognosis of asymptomatic hematuria were analyzed retrospectively in 431 children from Jan. 2001 to Dec . 2014. ResultsIn 431 children （197 males and 234 females） with asymptomatic hematuria, the mean age of ifrst visit was 5.52±2.77 years （8 months-17 years）. Four hundred and twenty-ifve cases had persistent microscopic hematuria and 6 cases had gross hematuria. Three hundred and iffteen cases （73.1%） were glomerular hematuria, among which 286 cases were isolated hematuria, 5 cases were acute glomerulonephritis, 13 cases were minimal change glomerulopathy, 4 cases were IgA nephropathy, 4 cases were mesangial proliferation glomerulonephritis and 3 cases were thin basement membrane nephropathy. One hundred and thirty-six cases （31.5%） were non-glomerular hematuria, among whom 113 cases were left renal vein entrap-ment syndrome, 17 cases were idiopathic hypercalciuria, 4 cases were kidney stone, 1 case was urinary tract infection and 1 case was left kidney absence. The mean follow-up period was 3.05±2.69 years （0.5-13.5 years）. One hundred and forty-ifve patients showed the resolution of microscopic hematuria, among whom 110 cases （75.8%） had the resolution in 3 years after the ifrst visit. In 24 cases with family history of hematuria, only 6 cases showed the resolution. At the end of the follow-up, renal function remained stable in all children.ConclusionsThe onset age of asymptomatic hematuria in children varies widely, and most of them are glomerular hematuria. Most children with isolated hematuria show resolution within three years after the ifrst visit. The children with familial hematuria may last longer. The isolated hematuria has good prognosis but needs to be followed up.

关 键 词：血尿 病因 随访 儿童 

分 类 号：R726.9[医药卫生—儿科]