Marra G, Oppezzo C, Barberis V, Bianchetti M G
Department of Pediatrics, Pediatric Renal Unit, Clinica De Marchi, Milan, Italy.
Acta Paediatr. 2003 Jun;92(6):734-6.
Efforts are currently made to detect vesicoureteric reflux (VUR) early after urinary infections in order to limit secondary renal damage. This study investigated the extent to which recommendations for the detection of VUR are put into practice, and their influence on the age at diagnosis.
The age at diagnosis of VUR after urinary tract infections was analysed in 126 patients (48M, 78F) referred to a tertiary centre in Milan between 1976 and 1999.
The median age at diagnosis was 34 mo in subjects born before and 8 mo (p < 0.001) in those born after 1988. The difference was statistically significant in female but not in male subjects. The figures from Milan were compared with those for 102 patients (35M, 65F) born between 1946 and 1970, treated in Melbourne and reported in 1976. In Melbourne the median age at diagnosis was 1-2 y for boys and 5-6 y for girls; in Milan, the corresponding figures were <1 y and 1-2 y. The difference between Melbourne and Milan was statistically significant for both genders.
In Milan VUR is now detected earlier than in the past. This trend is more marked in females than in males, but reflux is still detected earlier in boys.
目前致力于在尿路感染后早期检测膀胱输尿管反流（VUR），以限制继发性肾损害。本研究调查了VUR检测建议的实际执行程度及其对诊断年龄的影响。
分析了1976年至1999年间转诊至米兰一家三级中心的126例患者（48例男性，78例女性）尿路感染后VUR的诊断年龄。
1988年以前出生的受试者诊断时的中位年龄为34个月，1988年以后出生的受试者为8个月（p<0.001）。女性受试者的差异具有统计学意义，男性受试者则不然。将米兰的数据与1946年至1970年间出生、在墨尔本接受治疗并于1976年报告的102例患者（35例男性，65例女性）的数据进行比较。在墨尔本，男孩诊断时的中位年龄为1至2岁，女孩为5至6岁；在米兰，相应数字分别为<1岁和1至2岁。墨尔本和米兰之间的差异在两性中均具有统计学意义。
在米兰，VUR现在比过去检测得更早。这种趋势在女性中比在男性中更明显，但男孩的反流仍比女孩更早被检测到。
