Aver'anova N I, Balueva L G, Ivanova N V
Ter Arkh. 2013;85(12):75-8.
To evaluate the efficacy of nitrofurans in children and adolescents with pyelonephritis in the presence of crystalluria.
The study included 50 patients aged 4-14 years with chronic pyelonephritis in the presence of dysmetabolism. The patients underwent general blood test, general urinalysis with an urocytogram, bacteriological examination of urine, biochemical test of serum (uric acid, calcium, phosphorus, magnesium, urea, and creatinine) and 24-hour urinary excretion (uric acid, oxalates, calcium, phosphorus, and magnesium) at hospital admission and over time. The treatment regimen for Group 1 patients after antibiotic therapy involved furamag, Group 2 received furagin. The drugs were used in a dosage of 2 mg/kg/day in 2 divided doses for 14 days. Complaints, major clinical manifestations, crystalluria patterns, and a number of laboratory findings were analyzed over time.
The urinary sediment showed leukocyturia and bacteriuria in all the patients, oxaluria in 70% of the patients, uraturia in 10%, and mixed crystalluria in 20%. The main etiological agent of pyelonephritis was Escherichia coli (48.4%). Increased serum uric acid concentrations were revealed in 14% of the patients. Daily urine tests revealed hyperoxaluria, hyperuricosuria, and hypercalciuria in 86, 18, and 8% of the patients, respectively; urinary magnesium excretion was reduced in 86%. After treatment, Group 1 patients showed a more marked therapeutic effect in terms of a number of indicators (leukocyturia, crystalluria, uricosuria, magnesuria).
The results of the study showed that the antibacterial therapy involving antibiotics and nitrofurans for an exacerbation of chronic pyelonephritis in the presence of crystalluria not only provides an anti-inflammatory effect, but also leads to reductions in the level of crystalluria and the urinary content of uric acid and calcium. There was a significantly marked reduction in crystalluria, serum uric acid, and urinary oxalates and calcium in the children taking furamag. Out of nitrofurans, furamag may be recommended as the drug of choice to treat urinary tract infections in the presence of crystalluria.
评估呋喃类药物对存在结晶尿的儿童及青少年肾盂肾炎的疗效。
该研究纳入了50例年龄在4至14岁、患有慢性肾盂肾炎且伴有代谢紊乱的患者。患者在入院时及随访期间接受了血常规、尿常规及尿细胞图谱检查、尿液细菌学检查、血清生化检测（尿酸、钙、磷、镁、尿素及肌酐）以及24小时尿排泄检测（尿酸、草酸盐、钙、磷及镁）。1组患者在抗生素治疗后使用夫拉马吉，2组患者使用呋喃西林。药物剂量为2mg/kg/天，分2次给药，疗程14天。随时间分析患者的主诉、主要临床表现、结晶尿类型及多项实验室检查结果。
所有患者尿沉渣均显示白细胞尿和菌尿，70%的患者有草酸盐尿，10%有尿酸盐尿，20%有混合性结晶尿。肾盂肾炎的主要病原体为大肠埃希菌（48.4%）。14%的患者血清尿酸浓度升高。每日尿液检测显示，分别有86%、18%和8%的患者出现高草酸盐尿、高尿酸尿和高钙尿；86%的患者尿镁排泄减少。治疗后，1组患者在多项指标（白细胞尿、结晶尿、尿酸尿、镁尿）方面显示出更显著的治疗效果。
研究结果表明，在存在结晶尿的情况下，针对慢性肾盂肾炎急性发作采用抗生素联合呋喃类药物的抗菌治疗不仅具有抗炎作用，还能降低结晶尿水平以及尿酸和钙的尿含量。服用夫拉马吉的儿童结晶尿、血清尿酸以及尿草酸盐和钙显著减少。在存在结晶尿的情况下，呋喃类药物中，夫拉马吉可被推荐为治疗尿路感染的首选药物。
