Rosenberg A R, Rossleigh M A, Brydon M P, Bass S J, Leighton D M, Farnsworth R H
Department of Neprhology, Prince of Wales Children's Hospital, Sydney, Australia.
J Urol. 1992 Nov;148(5 Pt 2):1746-9. doi: 10.1016/s0022-5347(17)37019-2.
A prospective study examining the incidence of dimercaptosuccinic acid (DMSA) abnormalities in children at the time of acute urinary tract infection, the progression of these abnormalities following treatment and their correlation with the presence of vesicoureteral reflux is reported. DMSA scans performed within 72 hours of presentation in 65 previously healthy children with acute urinary tract infection were abnormal in 34 (52%). The scan appearances of 30 of 36 (83%) initially abnormal kidneys improved or became normal on the repeat DMSA study performed at 3 to 6 months after the acute urinary tract infection. A cystogram demonstrated significant vesicoureteral reflux in 11 of 45 cases (24%). Of these 11 cases 10 had abnormal DMSA studies and 1 had dilated upper tracts on ultrasound. Several conclusions may be drawn from our study. The incidence of DMSA abnormalities at the time of acute urinary tract infection is high but these abnormalities tend to resolve with time. An abnormal DMSA study at the time of urinary tract infection identifies most children with significant vesicoureteral reflux, and in our series a combination of ultrasound and DMSA identified all cases. This study may have major implications for the clinical investigation of children with urinary tract infection.
一项前瞻性研究报告了急性尿路感染患儿二巯基丁二酸（DMSA）异常的发生率、治疗后这些异常的进展情况及其与膀胱输尿管反流的相关性。对65名既往健康的急性尿路感染患儿在发病72小时内进行的DMSA扫描显示，34名（52%）患儿结果异常。在急性尿路感染后3至6个月进行的重复DMSA研究中，36例最初异常的肾脏中有30例（83%）扫描表现改善或恢复正常。膀胱造影显示45例中有11例（24%）存在明显的膀胱输尿管反流。在这11例中，10例DMSA研究结果异常，1例超声显示上尿路扩张。从我们的研究中可以得出几个结论。急性尿路感染时DMSA异常的发生率很高，但这些异常往往会随时间消退。尿路感染时DMSA研究结果异常可识别出大多数有明显膀胱输尿管反流的患儿，在我们的系列研究中，超声和DMSA联合检查可识别出所有病例。本研究可能对尿路感染患儿的临床研究具有重要意义。
