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小儿尿路感染中膀胱输尿管反流的患病率。

Prevalence of Vesicoureteral Reflux in Children with Urinary Tract Infection.

机构信息

Department of Pediatric Nephrology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Saudi J Kidney Dis Transpl. 2022 Aug;33(Supplement):S111-S120. doi: 10.4103/1319-2442.384183.

Abstract

Vesicoureteral reflux (VUR) is reported in 30%-50% of children affected by urinary tract infection (UTI). We aimed to investigate the frequency of VUR in children presenting with UTI and the changes in its prevalence from birth up to 18 years. This research was an observational retrospective study in the nephrology clinic of an academic tertiary hospital during 2003-2016. Patients with UTI subjected to direct cystourethrography were enrolled (908 patients, 86.23% of girls and 13.77% of boys). They were aged from 3 days to 214 months (33 ± 33.2 months). VUR was observed in 419 of 908 (46.14%) cases. High-grade VUR (VUR Grades IV-V) and VUR were significantly more prevalent in boys (P = 0.001 for both). Only 9.2% of the VUR subjects were diagnosed after 5 years of age. The patients with VUR developed UTI at a significantly younger age compared with those without VUR (P = 0.0001). Abnormal kidney ultrasound results were significantly more common in patients with VUR than in those without VUR (P = 0.0001). The prevalence of VUR in the 1, 2, 3, 4, and 5 years of life was estimated to be 56.64%, 48.2%, 49.46%, 35.8%, and 45.07%, respectively. The highest and lowest VUR prevalence was 56.64% (1 year of life) and 0% (13-18 years). In addition, severe VUR was not an uncommon finding, and affected 10.7% of the total population. The results indicated a decrease in the prevalence of VUR with increased age when considering the five main age subgroups of childhood.

摘要

输尿管反流(VUR)在患有尿路感染(UTI)的儿童中报告有 30%-50%。我们旨在调查患有 UTI 的儿童中 VUR 的频率以及从出生到 18 岁其患病率的变化。这项研究是 2003 年至 2016 年在一家学术性三级医院的肾病科进行的一项观察性回顾性研究。患有 UTI 并接受直接膀胱输尿管造影的患者被纳入研究(908 例患者,86.23%为女孩,13.77%为男孩)。患者年龄从 3 天到 214 个月(33 ± 33.2 个月)。在 908 例患者中观察到 419 例(46.14%)存在 VUR。高等级 VUR(VUR 等级 IV-V)和 VUR 在男孩中明显更为常见(P=0.001,均有统计学意义)。仅 9.2%的 VUR 患者在 5 岁后被诊断出。与无 VUR 的患者相比,患有 VUR 的患者发生 UTI 的年龄明显更小(P=0.0001)。与无 VUR 的患者相比,VUR 患者的异常肾脏超声结果更为常见(P=0.0001)。1 岁、2 岁、3 岁、4 岁和 5 岁时 VUR 的患病率估计分别为 56.64%、48.2%、49.46%、35.8%和 45.07%。VUR 患病率最高和最低的分别是 56.64%(1 岁)和 0%(13-18 岁)。此外,严重 VUR 也并不少见,占总人群的 10.7%。结果表明,当考虑儿童的五个主要年龄亚组时,VUR 的患病率随着年龄的增加而降低。

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