Pintér A B, Jászai V, Dóber I
Surgical Unit of Children's Department, University Medical School of Pécs, Hungary.
J Urol. 1988 Jul;140(1):121-4. doi: 10.1016/s0022-5347(17)41503-5.
Between 1970 and 1982, 41 neonates and infants with grades II and III vesicoureteral reflux (international classification) but with no medical or urological complications were treated medically and followed for an average of 7.5 years. In 33 of the 41 patients the vesicoureteral reflux resolved (group 1) and in 8 it persisted (group 2). The severity and frequency of urinary infection decreased to a greater degree in group 1 (p less than 0.0005) than in group 2 (p less than 0.05). There was no difference in endogenous creatinine clearance between the 2 groups. Comparison of kidney length and bipolar parenchymal thickness revealed that bipolar parenchymal thickness was significantly less in group 2 patients (p less than 0.01). Body weight tended to increase in both groups but it was greater in group 1. In both groups height was lower at the time of detection of reflux and it approached nearly normal values during followup. It is tempting to conclude that early recognition of mild forms of vesicoureteral reflux (grades II and III) and systematic medical treatment can preserve renal function and promote renal and somatic growth. However, this tendency is less pronounced in patients with persistent reflux.
1970年至1982年间，对41例患有II级和III级膀胱输尿管反流（国际分类）但无内科或泌尿外科并发症的新生儿和婴儿进行了药物治疗，并平均随访7.5年。41例患者中，33例膀胱输尿管反流消失（第1组），8例持续存在（第2组）。第1组尿路感染的严重程度和频率下降程度大于第2组（第1组p<0.0005，第2组p<0.05）。两组内生肌酐清除率无差异。肾长度和双极实质厚度的比较显示，第2组患者的双极实质厚度明显较小（p<0.01）。两组体重均有增加趋势，但第1组增加更明显。两组在反流检测时身高均较低，随访期间接近正常水平。由此很容易得出结论，早期识别轻度膀胱输尿管反流（II级和III级）并进行系统药物治疗可以保护肾功能，促进肾脏和身体生长。然而，这种趋势在反流持续的患者中不太明显。
