Schulte-Wissermann H, Beetz R, Ludwig K H, Mannhardt W, Schofer O, Tröger J, Riedmiller H, Hohenfellner R
Klin Wochenschr. 1985 Sep 16;63(18):920-6. doi: 10.1007/BF01738146.
62 patients (14 boys, 48 girls) representing 85 refluxive renal units (Grade 2-4) were investigated after successful operation for the development of further urinary tract infections (UTI) and renal scars (RS). The mean follow-up was 9.3 years. With the exception of one boy, none of the male patients developed any UTI or new RS. A similar result was obtained for about 45% of the girls. These two groups of patients presented with high-grade reflux before surgery. The remaining female patients (about 55%), however, presenting with lower-grade reflux before surgical treatment, developed further UTI as well as new RS despite surgical correction of their reflux. Investigations on the capacity of uroepithelial cells (UEC) to suppress bacterial growth revealed a deficient antibacterial effect of UEC in these patients. Such an UEC defect has also been shown in patients with asymptomatic bacteriuria. In conclusion, different reasons seem to be responsible for recurrent UTI and the development of RS in patients with reflux.
对62例患者（14名男孩，48名女孩）进行了研究，这些患者代表85个反流性肾单位（2 - 4级），他们在成功手术后接受了进一步尿路感染（UTI）和肾瘢痕（RS）发展情况的调查。平均随访时间为9.3年。除一名男孩外，男性患者均未发生任何尿路感染或新的肾瘢痕。约45%的女孩也得到了类似结果。这两组患者在手术前均表现为重度反流。然而，其余女性患者（约55%）在手术治疗前表现为轻度反流，尽管反流已通过手术矫正，但仍发生了进一步的尿路感染以及新的肾瘢痕。对尿上皮细胞（UEC）抑制细菌生长能力的研究表明，这些患者的尿上皮细胞抗菌作用不足。无症状菌尿患者也存在这种尿上皮细胞缺陷。总之，反流患者反复发生尿路感染和肾瘢痕形成的原因似乎各不相同。
