Wang Zheng, Luo Hong, Tu Wenwei, Yang Hui, Wong Wilfred Hing-Sang, Wong Wing-Tak, Yung Ka-Fu, Zhou Nan, Zhang Jingti, Li Xiaoqing, Wang Zerong, Guo Wenjun, Mu Dezhi, Li Fanghong, Mao Meng, Lau Yu-Lung
West China Second University Hospital, Sichuan University, Chengdu, China.
Pediatr Int. 2011 Aug;53(4):489-96. doi: 10.1111/j.1442-200X.2010.03284.x.
An outbreak of urinary stones related to consumption of melamine-tainted milk products (MTMP) occurred in China in 2008. The aim of the present study was to evaluate such children to identify their clinical features and risk factors.
Renal ultrasound was performed for 7328 children who presented to a Sichuan teaching hospital between 13 September and 15 October 2008 due to concern of such stones. Clinical data, family information, feeding history and urinary stones were analyzed.
Of the 7328 children, 189 (2.58%) had ultrasound findings of urinary stones, and 51 were admitted. Age (mean ± SD) was 27.4 ± 25.5 months, and 101 were male and 88, female. The odds ratio (OR) for urinary stones for infants and young children (1-3 years) as compared to older children (>3 years), was 2.42 (95% confidence interval [CI], 1.64-3.56; P < 0.0001) and 1.95 (95%CI, 1.31-2.89; P < 0.0011), respectively. Independent risk factors associated with urinary stones included consumption of MTMP with melamine at > 5500 mg/kg (OR, 13.3; 95%CI, 6.8-26.1, P < 0.0001) as compared to that with melamine at < 200 mg/kg, and younger father (P = 0.0006). On logistic regression, the only risk factor associated with inpatient care was lower family income per person (OR, 4.4; 95%CI, 1.2-15.9, P = 0.02). Repeat ultrasound for 51 children at mean follow up of 15.3 ± 8.9 days found that 33 passed out all stones, which was associated with a larger number of smaller stones (P = 0.003). Urinary stones contained melamine and uric acid, but no cyanuric acid.
MTMP-associated urinary stones were more frequent in young children and more severe in children from poorer families.
2008年中国发生了与食用受三聚氰胺污染的奶制品（MTMP）相关的尿路结石疫情。本研究的目的是对这些儿童进行评估，以确定其临床特征和危险因素。
对2008年9月13日至10月15日因担心尿路结石而到四川一家教学医院就诊的7328名儿童进行了肾脏超声检查。分析了临床资料、家庭信息、喂养史和尿路结石情况。
在7328名儿童中，189名（2.58%）超声检查发现有尿路结石，51名入院治疗。年龄（均值±标准差）为27.4±25.5个月，男性101名，女性88名。婴幼儿（1至3岁）与大龄儿童（>3岁）相比，尿路结石的优势比（OR）分别为2.42（95%置信区间[CI]，1.64 - 3.56；P < 0.0001）和1.95（95%CI，1.31 - 2.89；P < 0.0011）。与尿路结石相关的独立危险因素包括食用三聚氰胺含量>5500毫克/千克的MTMP（OR，13.3；95%CI，6.8 - 26.1，P < 0.0001）与三聚氰胺含量<200毫克/千克的MTMP相比，以及父亲年龄较小（P = 0.0006）。在逻辑回归分析中，与住院治疗相关的唯一危险因素是人均家庭收入较低（OR，4.4；95%CI，1.2 - 15.9，P = 0.02）。对51名儿童进行平均随访15.3±8.9天的重复超声检查发现，33名儿童排出了所有结石，这与结石数量较多且较小有关（P = 0 . 003）。尿路结石含有三聚氰胺和尿酸，但没有三聚氰酸。
与MTMP相关的尿路结石在幼儿中更为常见，在贫困家庭的儿童中更为严重。
