Simon J, Schoutens A, Thirion M, Schulman C
Service d'Urologie, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Belgique.
J Urol (Paris). 1987;93(4):187-91.
Fifty-two patients with vesicoureteral reflux (age: 6.4 +/- 6.2 years) were examined by IVP, voiding cystouretrography and 123 I-Hippuran studies. 17 patients were not operated; 26 had an antireflux, 9 an urethral surgery. The follow-up was 2 years for 39 of these patients, with at least one evaluation per year. The observations were: Unoperated patients were younger, had a lower radiological grade of reflux and renal functional impairment was less frequent. Functional impairment was initially equally distributed in unilateral (53%) and bilateral (54%) reflux. Radiological grade of reflux had an unsatisfactory predictive value for functional renal status. Functional renal status at 2 years was unchanged in 82% of patients. Improvement was observed in 8%, deterioration in 10%. These results were not influenced by the choice of treatment. However, reflux persistence was more frequently observed in the un-operated group (50% versus 5%). Renal transit times of 123 I-Hippuran did not correlate with the functional status or the radiological grade of reflux.
52例膀胱输尿管反流患者(年龄:6.4±6.2岁)接受了静脉肾盂造影(IVP)、排尿性膀胱尿道造影及123I-马尿酸盐检查。17例患者未接受手术;26例行抗反流手术,9例行尿道手术。其中39例患者随访2年,每年至少评估一次。观察结果如下:未手术患者年龄较小,反流的放射学分级较低,肾功能损害较少见。功能损害最初在单侧反流(53%)和双侧反流(54%)中分布相同。反流的放射学分级对肾功能状态的预测价值不理想。82%的患者2年时肾功能状态无变化。8%的患者有所改善,10%的患者出现恶化。这些结果不受治疗方式选择的影响。然而,未手术组反流持续存在的情况更常见(50%对5%)。123I-马尿酸盐的肾转运时间与功能状态或反流的放射学分级无关。