[1]王凌超,赵德安,毕凌云,等.肾外结核尿检结果异常患儿临床特点分析[J].新乡医学院学报,2018,35(10):884-888.[doi:10.7683/xxyxyxb.2018.10.009]
 WANG Ling-chao,ZHAO De-an,BI Ling-yun,et al.Clinical features analysis of children with extra-renal tuberculosis infection combined with abnormal findings in urinalysis[J].Journal of Xinxiang Medical University,2018,35(10):884-888.[doi:10.7683/xxyxyxb.2018.10.009]
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肾外结核尿检结果异常患儿临床特点分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年10
页码:
884-888
栏目:
临床研究
出版日期:
2018-10-05

文章信息/Info

Title:
Clinical features analysis of children with extra-renal tuberculosis infection combined with abnormal findings in urinalysis
作者:
王凌超1赵德安1毕凌云1潘笑悦2刘 鑫1杨达胜1
(1.新乡医学院第一附属医院儿内科,河南 卫辉 453100;2.河南科技大学第一附属医院儿内科,河南 洛阳 471000)
Author(s):
WANG Ling-chao1ZHAO De-an1BI Ling-yun1PAN Xiao-yue2LIU Xin1YANG Da-sheng1
(1.Department of Pediatrics,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;2.Department of Pediatrics,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan Province,China)
关键词:
儿童结核感染尿检异常血尿蛋白尿
Keywords:
childrentuberculosis infectionabnormal findings in urinalysishematuriaproteinuriakidney
分类号:
R52
DOI:
10.7683/xxyxyxb.2018.10.009
文献标志码:
A
摘要:
目的 探讨肾外结核尿检结果异常患儿的临床特点。方法 回顾性分析新乡医学院第一附属医院2014年1~12月收治的270例肾外结核患儿的临床资料,总结肾外结核尿检异常患儿的临床特点。结果 270例肾外结核患儿中尿检异常者57例(21.1%),其中仅蛋白尿者27例(47.4%),仅血尿者20例(35.1%),蛋白尿合并血尿者10例(17.5%)。入院前未应用抗结核药物患儿尿检异常检出率与入院前应用抗结核药物患儿比较差异无统计学意义(χ2=1.354,P>0.05)。肺合并骨关节结核、肺合并肝脏和腹壁结核、肺合并脑和骨关节结核患儿尿检异常检出率最高(均为100%),肺和(或)胸膜结核患者尿检异常检出率最低(14.5%)。2个及2个以上部位结核感染者尿检异常检出率高于单部位感染者(χ2=12.952,P<0.05)。57例肾外结核尿检异常患儿男女比例1.28∶1,发病年龄高峰在17~18岁(61.4%);发病部位以肺和(或)胸膜最多见(54.4%);临床表现主要以结核中毒症状为主,泌尿系统症状表现不明显。结论 肾外结核尿检异常患儿临床表现以蛋白尿、血尿为主;对于肾外结核感染部位较多的青少年患儿,应高度重视肾累及的可能。
Abstract:
Objective To analyze the clinical features of children with renal-extra tuberculosis infection combined with urinary abnormalities.Methods The clinical data of 270 children with extra-renal tuberculosis from January to December of 2014 in the First Affiliated Hospital of Xinxiang Medical University were analyzed retrospectively.The clinical features of children with extra-renal tuberculosis infection combined with abnormal findings in urinalysis were analyzed.Results Fifty-seven children with urinary abnormalities were detected from 270 children with extra-renal tuberculosis.And the urinary abnormalities detection rate was 21.1%involving simple proteinuria in 27 cases(47.4%),simple hematuria in 20 cases(35.1%),proteinuria and hematuria in 10 cases(17.5%).There was no significant difference in the urinary abnormalities detection rate between children who did not take anti-tuberculosis drugs before admission and those who took anti-tuberculosis drugs before hospitalization(χ2=1.354,P>0.05).The urinary abnormalities detection rate was the highest in lung combined with bone and joint tuberculosis,lung combined with liver,abdominal tuberculosis and lung combined with brain,bone and joint tuberculosis patients(all 100%),and the urinary abnormalities detection rate of lung and/or pleural tuberculosis patients was the lowest (14.5%).The detection rate of abnormal urine test in children with 2 or more tuberculosis infection sites was higher than that in single site (χ2=12.952,P<0.05).The male to female ratio in 57 urine abnormalities children with extra-renal tuberculosis was 1.28∶1.The peak age of onset was 17-18 years old(61.4%).The lung and/or pleural tuberculosis was the most common sites (54.4%).The clinical manifestations were mainly tuberculosis poisoning symptoms,and however,the symptoms of urinary system were not obvious.Conclusion The renal involvement of children with extra-renal tuberculosis is mainly characterized by proteinuria and hematuria.For adolescent patients with more extra-renal tuberculosis infection sites,the possibility of kidney involvement should be weighed carefully by clinicians.

参考文献/References:

[1] CHUNG H S,LEE J H.Bronchoscopic assessment of the evolution of endobronchial tuberculosis[J].Chest,2000,117(2):385-392.
[2] ORGANIZATION W H.Global tuberculosis report-2014[J].Australas Med J,2013,6(2):1.
[3] 马祖祥,易著文.肾病综合征与结核病[J].国外医学(儿科学分册),1999,26(3):46-48.
[4] WHO GUIDELINES APPROVED BY THE GUIDELINES REVIEW COMMITTEE.Guidance for national tuberculosis programmes on the management of tuberculosis in children[M].2nd edition.Geneva:World Health Organization,2014:21.
[5] 熊立凡.临床检验基础[M].3版.北京:人民卫生出版社,2003:165.
[6] 丛玉隆.血液学体液学检验与临床释疑[M].北京:人民军医出版社,2004:66-68.
[7] 叶应妩,王毓三,申子瑜.全国临床检验操作规程[M].南京:东南大学出社,2006:293.
[8] WOOD R,JOHNSTONEROBERTSON S,UYS P,et al.Tuberculosis transmission to young children in a south African community:modeling household and community infection risks[J].Clin Infect Dis,2010,51(4):401-408.
[9] 王黎霞,成诗明,陈明亭,等.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
[10] TADA T,OHARA A,NAGAI Y,et al.A case report of nephrotic syndrome associated with rifampicin therapy[J].Nihon Jinzo Gakkai Shi,1995,37(2):145-150.
[11] 辛茶香,刘珍琼,熊国亮.荧光定量PCR技术检测结核分支杆菌DNA的应用价值[J].国际检验医学杂志,2007,28(3):196-197.
[12] TOMONAGA H.Detection of antibody specific to rifampicin metabolite by ELISA-mechanism of sensitization by rifampicin[J].Arerugi,1993,42(7):854-863.
[13] 全国儿科肾脏病学组.儿童泌尿系统疾病流行病学调查—全国21省市尿筛查小结[J].中华儿科杂志,1988,27(2):304-306.
[14] 匡红,林波,李静,等.细菌培养与尿沉渣细菌定量分析在尿路感染诊断中的应用[J].国际检验医学杂志,2013,34(16):2115-2116.
[15] 雷晓燕,王三萍,赛依帕,等.兰州市10795名中小学生尿筛查及随访情况分析[J].临床儿科杂志,2014,32(10):961.
[16] DEMKOW U,ZIOLKOWSKI J,BIALASCHROMIEC B,et al.Humoral immune response against mycobacterial antigens in children with tuberculosis[J].J Physiol Pharmacol,2006,57(4):63-73.
[17] RAJA A,RANGANATHAN U D,RAMALINGAM B,et al.Clinical value of specific detection of immune complex-bound antibodies in pulmonary tuberculosis[J].Diagn Microbiol Infect Dis,2006,56(3):281-287.
[18] TASNEEM S,ISLAM N,ALI R,et al.Crossreactivity of SLE autoantibodies with 70 kDa heat shock proteins of Mycobacterium tuberculosis[J].Microbiol Immunol,2013,45(12):841-846.
[19] 马祖祥,旷寿金,鲍燕敏,等.结核杆菌相关性肾炎的实验研究[J].实用预防医学,2004,11(4):749-751.
[20] LI S,SIYUAN T,JIANGMIN F,et al.Analysis of the association between Mycobacterium tuberculosis infection and immunoglobulin A nephropathy by early secreted antigenic target 6 detection in renal biopsies:a prospective study[J].Postgrad Med,2017,129(3):307-311.
[21] 孙立,冯江敏,张艳宁,等.结核杆菌分泌性抗原Ag85与ESAT-6在肾结核感染诊断中的意义[J].中国慢性病预防与控制,2012,20(4):445-446.
[22] 匡载星,肖立禄,简继文.60例肾结核临床诊治分析[J].实用临床医学,2013,14(1):54-56.
[23] 韩蕊,叶志斌.结核与肾脏疾病[J].中华临床医师杂志:电子版,2013,7(19):8882-8885.DOI:10.3877/cma.j.issn.1674-0785.2013.19.079.
[24] 孙立.早期诊断结核杆菌相关肾损伤的实验性研究[D].沈阳:中国医科大学,2010.

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[2]于贵珍,郑素华,张文林,等.1120例儿童及青少年行为问题的调查研究[J].新乡医学院学报,1990,7(03):201.
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[7]薛克修,陈金兰,支凌翔,等.儿童前臂缺血性挛缩的治疗[J].新乡医学院学报,1996,13(04):384.
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[9]郑素华,付桂玲,张文林,等.行为异常儿童社交能力分析[J].新乡医学院学报,1997,14(04):363.
[10]贾东萱,石太新,贾汝贤,等.小儿恶性肿瘤及白血病226例回顾性分析[J].新乡医学院学报,1997,14(04):405.

更新日期/Last Update: 2018-10-05