Lieu T A, Grasmeder H M, Kaplan B S
Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine.
Pediatr Clin North Am. 1991 Jun;38(3):579-92. doi: 10.1016/s0031-3955(16)38119-6.
Persistent microscopic hematuria in children is most often benign or untreatable. The evaluation of microscopic hematuria in an otherwise healthy child need not require invasive and costly laboratory studies. The initial evaluation must look for signs of life-threatening causes of hematuria, i.e., hypertension, edema, oliguria, or significant proteinuria. If these are absent, a stepwise evaluation is suggested, which includes microscopic examination of the urine for red blood cell casts, a test for proteinuria, serum creatinine, and serial follow-up. Renal biopsy may establish a diagnosis but rarely changes the treatment in a child with asymptomatic isolated microscopic hematuria.
儿童持续性镜下血尿大多为良性或无法治疗。对原本健康的儿童进行镜下血尿评估，无需进行侵入性且昂贵的实验室检查。初始评估必须寻找威胁生命的血尿病因迹象，即高血压、水肿、少尿或大量蛋白尿。若不存在这些情况，建议进行逐步评估，包括对尿液进行红细胞管型显微镜检查、蛋白尿检测、血清肌酐检测及系列随访。肾活检可能会明确诊断，但对于无症状孤立性镜下血尿患儿，很少会改变治疗方案。
