[膀胱输尿管反流患儿的排尿功能障碍]

[Voiding dysfunction in children with vesicoureteral reflux].

作者信息

Szymanik-Grzelak Hanna, Sladowska Joanna, Pańczyk-Tomaszewska Małgorzata, Sekowska Renata, Roszkowska-Blaim Maria

机构信息

Katedra i Klinika Pediatrii i Nefrologii, Akademii Medycznej w Warszawie.

出版信息

Przegl Lek. 2006;63 Suppl 3:142-5.

PMID:16898514

Abstract

UNLABELLED

The aim of the study was to assess the rate of development of voiding dysfunction (VD) in patients with reflux nephropathy. We investigated 150 pts with vesicoureteral reflux (VUR): 33 boys and 117 girls in mean age 9 +/- 3.3 years with normal renal function. In all pts we performed renal scintigraphy (DMSA) and ABPM. Renal scarring by DMSA scan was categorized into grades 1-4. In all pts we assessed high and laterality of VUR, renal function (clearance creatinine--Ccr) and occurency of hypertension (HT).

RESULTS

Of 150 pts, 80 (53.3%) developed VD (54.5% boys and 52% girls). DMSA grade: 1--27 pts, 2--85 pts; 3--31 pts; 4--7 pts. No statistically significant difference was found depends of: sex, age, laterality of renal damage in DMSA, unilateral and bilateral reflux for the development of VD. The incidence 3-4 grade in DMSA scan was significantly higher in pts with IV-V grade of VUR in comparison to pts with lower grade of VUR in group with and without voiding dysfunction. IV-V grades of VUR were observed more frequently in pts with bladder/sphincter dysfunction. The occurency of HT in group with VD and without VD was 12 pts (15%) and 8 (11.4%) respectively (ns). Pts with VD have lower Ccr in comparison with pts without VD (129.1 vs 136.3 ml/min/1.73 m2; p<0.05).

CONCLUSIONS

Approximately 50% of patients with VUR demonstrated VD. VD occurred independent of age. IV-V degrees VUR and more severe changes in DMSA scan were seen in pts with bladder/sphincter dysfunction.

摘要

未标注

本研究的目的是评估反流性肾病患者排尿功能障碍（VD）的发生率。我们调查了150例膀胱输尿管反流（VUR）患者：33名男孩和117名女孩，平均年龄9±3.3岁，肾功能正常。对所有患者均进行了肾闪烁显像（DMSA）和动态血压监测（ABPM）。通过DMSA扫描将肾瘢痕分为1 - 4级。对所有患者评估VUR的严重程度和部位、肾功能（肌酐清除率——Ccr）以及高血压（HT）的发生率。

结果

150例患者中，80例（53.3%）出现VD（男孩为54.5%，女孩为52%）。DMSA分级：1级——27例，2级——85例；3级——31例；4级——7例。在VD的发生方面，未发现性别、年龄、DMSA中肾损伤部位、单侧和双侧反流有统计学显著差异。与排尿功能正常和异常组中VUR分级较低的患者相比，VUR为IV - V级的患者DMSA扫描中3 - 4级的发生率显著更高。膀胱/括约肌功能障碍的患者中更频繁观察到IV - V级VUR。有VD组和无VD组的HT发生率分别为12例（15%）和8例（11.4%）（无统计学差异）。与无VD的患者相比，有VD的患者Ccr较低（129.1对136.3 ml/min/1.73 m2；p<0.05）。