Diamond D A, Rickwood A M, Lee P H, Johnston J H
Department of Urology, Alder Hey Children's Hospital, Liverpool, England.
Urology. 1994 Apr;43(4):525-7. doi: 10.1016/0090-4295(94)90247-x.
The objective of this study was to determine the relationship between urinary tract infection and pediatric urolithiasis and to characterize the pediatric infection stone former.
Two hundred seventy consecutive pediatric stone formers presenting over a twenty-seven-year period were studied. Of these, 161 children (60%) had infection-related stones. Account was taken of stone composition, anatomic location, associated anatomic lesions, and the rate of stone recurrence over a median follow-up of three years.
The mean age of children with infection stones was 4.9 years, with two-thirds being under six years of age. Proteus mirabilis accounted for 82 percent of pure urine cultures. Seventy percent of stones were renal and 30 percent were ureteral or intravesical. One-third of patients had anatomic lesions (pelviureteric obstruction, primary obstructed megaureter, and others) contributing to stone formation. Recurrent stones occurred in 14 percent of cases.
This study reaffirms the predominance of urinary tract infection secondary to P. mirabilis as the leading cause of pediatric urolithiasis in the United Kingdom. The significant recurrence rate suggests the importance of prophylactic antibiotics, surgical correction of congenital anomalies, and long-term follow-up of this patient population.
本研究旨在确定尿路感染与小儿尿路结石之间的关系，并对小儿感染性结石患者进行特征描述。
对连续27年中出现的270例小儿结石患者进行研究。其中，161例儿童（60%）患有与感染相关的结石。研究考虑了结石成分、解剖位置、相关解剖病变以及在三年中位随访期内的结石复发率。
感染性结石患儿的平均年龄为4.9岁，其中三分之二年龄在6岁以下。奇异变形杆菌在纯尿培养中占82%。70%的结石位于肾脏，30%位于输尿管或膀胱内。三分之一的患者有导致结石形成的解剖病变（肾盂输尿管梗阻、原发性梗阻性巨输尿管等）。14%的病例出现复发性结石。
本研究再次证实，在英国，奇异变形杆菌继发的尿路感染是小儿尿路结石的主要原因。较高的复发率表明预防性使用抗生素、手术矫正先天性异常以及对该患者群体进行长期随访的重要性。
