Laurenti C, De Dominicis C, Franco G, Dal Forno S, Iori F
J Urol (Paris). 1986;92(5):285-9.
Idiopathic macrohematuria represents 14 to 15% of all macroscopic hematurias in children, being more frequent than in adults (5 to 8%). Of 45 children admitted with this affection between 1968 and 1982, 45 were followed up regularly over 2 to 16 years (mean 9 years). Initial investigations included urine cytobacteriology, blood tests, urography and mictional cysto-urethrography, cystoscopy, immunology and renal ultrasound imaging (since 1978). Review examinations were comprised of blood and urine biologic tests, a standard abdominal radiograph, renal and bladder ultrasound imaging and urography (in 19 cases with persistent macro- or micro-hematuria). Of these 45 cases, macrohematuria was no longer present after 1 year in 31 cases (69%), and persisted for a maximum of 8 years until finally disappearing in 10 cases (22%): it persisted without change in 4 cases (8.8%). During follow up surveillance, 37 children (82.2%) failed to present any urinary affection, but 8 children (17.8%) were found to have urologic or nephrologic disease possibly responsible for the hematurial (including 5 cases of lithiasis). Analysis of findings showed associated urinary affections in 6% of cases when hematuria ceased before the 1st year and in 36% when it persisted. At the present time all 45 children have normal renal function, and idiopathic macrohematuria in children can be considered to be a benign lesion when the diagnosis is confirmed by very complete investigations.
特发性肉眼血尿占儿童所有肉眼血尿病例的14%至15%，比成人更为常见（成人中占5%至8%）。在1968年至1982年间收治的45例患此病的儿童中，45例接受了2至16年的定期随访（平均9年）。初始检查包括尿细菌学检查、血液检查、尿路造影和排尿期膀胱尿道造影、膀胱镜检查、免疫学检查以及肾脏超声成像（自1978年起）。复查检查包括血液和尿液生物学检查、标准腹部X线片、肾脏和膀胱超声成像以及尿路造影（19例持续性肉眼或镜下血尿患者）。在这45例病例中，31例（69%）在1年后肉眼血尿消失，10例（22%）最长持续8年直至最终消失，4例（8.8%）持续无变化。在随访监测期间，37名儿童（82.2%）未出现任何泌尿系统疾病，但8名儿童（17.8%）被发现患有可能导致血尿的泌尿系统或肾脏疾病（包括5例结石）。对检查结果的分析显示，血尿在第1年前消失的病例中有6%伴有相关泌尿系统疾病，而血尿持续的病例中有36%伴有相关泌尿系统疾病。目前，所有45名儿童的肾功能均正常，当通过非常全面的检查确诊后，儿童特发性肉眼血尿可被视为一种良性病变。
