Bael An M, Lax Hildegard, Hirche Herbert, Hjälms Kelm, Tamminen-Möbius Tytti, Van Hoeck Koen M, van Gool Jan D
Department of Pediatric Nephrology, University Hospital Antwerp, Antwerp, Belgium.
J Urol. 2006 Oct;176(4 Pt 1):1596-600. doi: 10.1016/j.juro.2006.06.037.
Linear correlations for cystometric/cystographic bladder capacity with age universally serve as clinical yardsticks in pediatric urology and nephrology. However, these correlations do not account for growth or the range in values, as the relation of cystometric/cystographic bladder capacity with age is nonlinear. Also, vesicoureteral reflux might influence the size of cystometric/cystographic bladder capacity, since small and large bladder capacities have been reported in conjunction with reflux. We decided to use the data sets of the International Reflux Study in Children to construct full reference ranges for cystometric/cystographic bladder capacity and age, for comparison with existing reference ranges in normal children, and to study the relation between bladder capacity and refluxing volume.
In the International Reflux Study in Children 386 patients with grade III or IV vesicoureteral reflux were followed with isotope cystography for 10 years. To follow the grade of reflux, x-ray cystography was also used at 60-month intervals. The 386 children, who were 1 month to 12 years old, were randomized into 2 groups-those undergoing surgery and those receiving medical treatment. For both groups data were available on cystometric/cystographic bladder capacity, refluxing volume, reflux grade and reflux outcome.
The distribution of cystometric/cystographic bladder capacity vs age is logarithmic, with a wide range between the 5th and 95th percentiles, and a clear nonlinear relation between bladder capacity and age (p < 0.001). Gender has no influence on cystometric/cystographic bladder capacity. No difference in bladder capacity exists between persistence or resolution of vesicoureteral reflux (p < 0.78), between grade III and grade IV reflux (p < 0.94), or between unilateral and bilateral reflux (p < 0.74). Thus, refluxing volume correlated only with reflux grade, not with cystometric/cystographic bladder capacity or age.
With or without vesicoureteral reflux values for cystometric/cystographic bladder capacity range widely in children, and correlate logarithmically with age. For clinical decisions the full reference range for age, flanked by the 5th and 95th percentiles, should be used to assess individual values for cystometric/cystographic bladder capacity, rather than linear functions.
膀胱测压/膀胱造影膀胱容量与年龄的线性相关性普遍用作小儿泌尿外科和肾脏病学的临床标准。然而，这些相关性并未考虑生长情况或数值范围，因为膀胱测压/膀胱造影膀胱容量与年龄的关系是非线性的。此外，膀胱输尿管反流可能会影响膀胱测压/膀胱造影膀胱容量的大小，因为已有报道膀胱容量大小与反流相关。我们决定使用国际儿童反流研究的数据集来构建膀胱测压/膀胱造影膀胱容量和年龄的完整参考范围，以便与正常儿童现有的参考范围进行比较，并研究膀胱容量与反流体积之间的关系。
在国际儿童反流研究中，对386例III级或IV级膀胱输尿管反流患者进行了为期10年的同位素膀胱造影随访。为了跟踪反流程度，还每隔60个月进行一次X线膀胱造影。这386名年龄在1个月至12岁之间的儿童被随机分为两组，一组接受手术治疗，另一组接受药物治疗。两组均有关于膀胱测压/膀胱造影膀胱容量、反流体积、反流程度和反流结果的数据。
膀胱测压/膀胱造影膀胱容量与年龄的分布呈对数关系，第5百分位数和第95百分位数之间范围很广，且膀胱容量与年龄之间存在明显的非线性关系（p<0.001）。性别对膀胱测压/膀胱造影膀胱容量没有影响。膀胱输尿管反流持续或缓解之间（p<0.78）、III级和IV级反流之间（p<0.94）或单侧和双侧反流之间（p<0.74）膀胱容量均无差异。因此，反流体积仅与反流程度相关，与膀胱测压/膀胱造影膀胱容量或年龄无关。
无论有无膀胱输尿管反流，儿童膀胱测压/膀胱造影膀胱容量值范围广泛，且与年龄呈对数相关。为了做出临床决策，应使用第5百分位数和第95百分位数两侧的年龄完整参考范围来评估膀胱测压/膀胱造影膀胱容量的个体值，而不是线性函数。
