Doehring E, Ehrich J H, Vester U, Feldmeier H, Poggensee U, Brodehl J
Kidney Int. 1985 Sep;28(3):520-5. doi: 10.1038/ki.1985.159.
Quantitative parasitological assessment and quantitative analysis of proteinuria, hematuria, and leukocyturia were carried out in 182 Sudanese schoolboys with mixed urinary and intestinal schistosomiasis. Pathological proteinuria was found in 73% of patients (median = 380, 95% confidence limits = 200 to 500 mg/liter). The median protein/creatinine ratio was 0.54. SDS polyacrylamide gel electrophoresis showed an excretion of albumin, transferrin, and IgG consistent with a postrenal pattern of proteinuria. Pathological erythrocyturia occurred in 84% of patients (median = 255, 95% CL = 95 to 629 cells/microliter) and leukocyturia in 77% of patients (median = 148, 95% CL = 93 to 246 cells/microliter). Phase contrast microscopy revealed intact erythrocytes, suggestive of postrenal hemorrhage. Proteinuria, erythrocyturia, and leukocyturia correlated significantly with the ova excretion in the urine, but not with egg excretion in the stool. Oxamniquine reduced ova excretion in the stool but did not influence pathological urine findings. In patients treated effectively with Praziquantel or Metrifonate, pathological PU, EU, and LU decreased markedly 1 month post treatment. PU in severely proteinuric patients reached physiological values 5 months post therapy. We suggest that the proteinuria, erythrocyturia, and leukocyturia in mixed schistosomiasis were of postrenal origin.
对182名患有混合性泌尿和肠道血吸虫病的苏丹男学生进行了寄生虫学定量评估以及蛋白尿、血尿和白细胞尿的定量分析。73%的患者出现病理性蛋白尿（中位数 = 380，95%置信区间 = 200至500毫克/升）。蛋白质/肌酐比值中位数为0.54。十二烷基硫酸钠聚丙烯酰胺凝胶电泳显示白蛋白、转铁蛋白和IgG的排泄符合肾后性蛋白尿模式。84%的患者出现病理性红细胞尿（中位数 = 255，95%置信区间 = 95至629个细胞/微升），77%的患者出现白细胞尿（中位数 = 148，95%置信区间 = 93至246个细胞/微升）。相差显微镜检查发现红细胞完整，提示肾后出血。蛋白尿、红细胞尿和白细胞尿与尿中虫卵排泄显著相关，但与粪便中虫卵排泄无关。奥沙尼喹减少了粪便中虫卵排泄，但不影响病理性尿液检查结果。在接受吡喹酮或敌百虫有效治疗的患者中，治疗后1个月病理性蛋白尿、红细胞尿和白细胞尿明显减少。重度蛋白尿患者的蛋白尿在治疗后5个月达到生理值。我们认为，混合性血吸虫病中的蛋白尿、红细胞尿和白细胞尿起源于肾后。
