Lam Hugh S, Ng Pak C, Chu Winnie C W, Wong William, Chan Dorothy F Y, Ho Stella S, Wong Ka T, Ahuja Anil T, Li Chi K
Department of Paediatrics, The Chinese University of Hong Kong.
BMJ. 2008 Dec 18;337:a2991. doi: 10.1136/bmj.a2991.
To investigate the renal outcomes of children after exposure to low dose melamine in Hong Kong.
Cross sectional study.
Special assessment centres, Hong Kong.
3170 children (1422 girls and 1748 boys) aged 12 years or less referred from territory-wide primary care clinics after daily consumption for one month or more of milk products tainted with melamine.
Presence of renal stones and haematuria.
One child had a confirmed renal stone, seven were suspected of having melamine related renal deposits, and 208 (6.6%) were positive for blood in urine by reagent strip. A proportion of these children were followed up at the special assessment centre, but only 7.4% of those positive for blood on reagent strip were confirmed by microscopy, suggesting an overall estimated prevalence of less than 1% for microscopic haematuria.
No severe adverse renal outcomes, such as acute renal failure or urinary tract obstruction, were detected in children after exposure to low dose melamine. Our results were similar to territory-wide findings in Hong Kong. Even including the seven children with suspected renal deposits, the prevalence of suspected melamine related abnormalities on ultrasonography was only 0.2%. None of these children required specific treatment. The prevalence of microscopic haematuria was probably overestimated by the reagent strip. These data suggest that large scale and urgent screening programmes may not be informative or cost effective for populations who have been exposed to low dose melamine.
调查香港儿童接触低剂量三聚氰胺后的肾脏结局。
横断面研究。
香港特别评估中心。
3170名12岁及以下儿童（1422名女孩和1748名男孩），他们在饮用受三聚氰胺污染的奶制品一个月或更长时间后，从全港基层医疗诊所转诊而来。
肾结石和血尿的存在情况。
1名儿童确诊有肾结石，7名疑似有与三聚氰胺相关的肾脏沉积物；208名儿童（6.6%）尿试纸检测尿潜血呈阳性。其中部分儿童在特别评估中心接受了随访，但尿试纸检测呈阳性的儿童中只有7.4%经显微镜检查确诊，提示镜下血尿的总体估计患病率低于1%。
在接触低剂量三聚氰胺的儿童中未检测到严重的不良肾脏结局，如急性肾衰竭或尿路梗阻。我们的结果与香港全港范围的调查结果相似。即使将7名疑似有肾脏沉积物的儿童包括在内，超声检查中疑似与三聚氰胺相关异常的患病率也仅为0.2%。这些儿童均无需特殊治疗。尿试纸可能高估了镜下血尿的患病率。这些数据表明，对于接触低剂量三聚氰胺的人群，大规模紧急筛查项目可能既无实际意义，也不具有成本效益。
