Supavekin Suroj, Kucivilize Kanittha, Hunnangkul Saowalak, Sriprapaporn Jiraporn, Pattaragarn Anirut, Sumboonnanonda Achra
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2006 Aug;89 Suppl 2:S41-7.
Assess the relation of age and sex in vesico ureteral reflux (VUR) and renal scarring and the relation of VUR and renal scarring in childhood urinary tract infection.
A descriptive study of one hundred and twenty-six children who received renal cortical scintigraphy from 1st Jan 2000 to 31st Dec 2004 in the Department of Radiology, Faculty of Medicine Siriraj Hospital, was conducted. Ninety-three (50 males, 43 females) patients were diagnosed with urinary tract infections (UTIs) but only ninety-one of them had renal cortical scintigraphic results available. The male to female ratio was 1.16:1. The mean age of the patients was 4.33 years (SD +/- 4.17, range 7 days-16 years). During the 1st year of life the male to female ratio is 2.6:1. Fever, dysuria, and poor feeding were the most presenting signs and symptoms. Eighty-five (45 males, 40 females) patients received Voiding Cysto Urethro Gram (VCUG).
The authors did not find the correlation between the age groups and sex with VCUG results on right and left side, respectively (p = 0.856, p = 0.145, p = 0.77, p = 0.75). Ninety-one (49 males, 42 females) patients received DMSA renal scintigraphy. Fifty-two patients (57.1%) had abnormal DMSA renal scan results. However; the authors did not find the correlation between age groups and sex with DMSA renal scan results on the right and left kidneys, respectively. (p = 0.202, p = 0.416, p = 0.511, p = 0.791). The authors compared times of UTIs with and DMSA renal scintigraphy in each side of the kidney. Even though the authors did find the correlation between episodes of UTIs and abnormal DMSA on the left kidneys (p = 0.017), it was not found on the right kidneys (p = 0.081). There were 80 patients who received both VCUG and DMSA renal scintigraphy. The authors found the correlation between severity of VUR and abnormal DMSA results on right and left kidneys (p = 0.001, p = 0.01).
The authors recommend that all children who have repeated UTI and/or VUR, irrespective of age and sex, should receive DMSA renal scintigraphy to detect renal scarring and follow up future complications.
评估膀胱输尿管反流（VUR）及肾瘢痕形成中年龄与性别的关系，以及儿童尿路感染中VUR与肾瘢痕形成的关系。
对2000年1月1日至2004年12月31日在诗里拉吉医院医学院放射科接受肾皮质闪烁扫描的126例儿童进行描述性研究。93例（50例男性，43例女性）患者被诊断为尿路感染（UTIs），但其中只有91例有肾皮质闪烁扫描结果。男女比例为1.16:1。患者的平均年龄为4.33岁（标准差±4.17，范围7天至16岁）。在1岁以内，男女比例为2.6:1。发热、排尿困难和喂养困难是最常见的症状和体征。85例（45例男性，40例女性）患者接受了排尿性膀胱尿道造影（VCUG）。
作者未发现年龄组和性别与左右两侧VCUG结果之间的相关性（p = 0.856，p = 0.145，p = 0.77，p = 0.75）。91例（49例男性，42例女性）患者接受了二巯基丁二酸（DMSA）肾闪烁扫描。52例患者（57.1%）DMSA肾扫描结果异常。然而，作者未发现年龄组和性别与左右肾DMSA肾扫描结果之间的相关性（p = 0.202，p = 0.416，p = 0.511，p = 0.791）。作者比较了尿路感染次数与两侧肾脏DMSA肾闪烁扫描结果。尽管作者发现尿路感染发作与左肾DMSA异常之间存在相关性（p = 0.017），但右肾未发现（p = 0.081）。80例患者同时接受了VCUG和DMSA肾闪烁扫描。作者发现VUR严重程度与左右肾DMSA结果之间存在相关性（p = ０.001，p = 0.01）。
作者建议，所有反复发生UTI和/或VUR的儿童，无论年龄和性别，均应接受DMSA肾闪烁扫描以检测肾瘢痕形成并随访未来并发症。
