摘要
目的 探讨膀胱输尿管返流 (VUR)与急性肾盂肾炎 (APN)后肾瘢痕形成的关系及评价小儿泌尿道感染 (UTI)核素显像方法。方法 研究对象为临床首次诊断为上尿路感染的患儿 4 8例 ,均经99Tcm 二巯基丁二酸 (DMSA)肾皮质显像确诊为APN。肾显像后 10d内行直接法放射性核素膀胱显像 (DRC)以评价VUR。结果 ①肾皮质显像示 2 9 2 % (14 4 8例 )患儿APN伴瘢痕形成。DRC示4 7 9% (2 3 4 8例 )患儿、4 4 8% (30 6 7个 )病变肾存在VUR。②伴瘢痕形成APN患儿 ,其VUR发生率为 85 7% ,明显高于无瘢痕者 (32 4 % ,P <0 0 1) ;伴瘢痕肾VUR发生率为 88 2 % ,明显高于无瘢痕肾(30 0 % ,P <0 0 1)。③有VUR的 30个肾中 ,重度VUR侧肾瘢痕发生率为 73 3% ,明显高于无VUR及轻、中度VUR侧肾 (11 5 % ,P <0 0 1)。结论 证实VUR是诱发APN后肾瘢痕形成的危险因素之一。DRC为一辐射低、灵敏度高的评价VUR的方法 。
Objective To determine the relationship between vesico ureteral reflux(VUR) and acute pyelonephritis(APN), renal scarring and to evaluate the radionuclide imaging in children with urinary tract infection(UTI) Methods The study included 48 children with upper urinary tract infection (UUTI) proven for the first time clinically All children were diagnosed as with APN by 99 Tc m dimercaptosuccinic acid (DMSA) renal cortical scintigraphy Within 10 d after renal imaging, all cases underwent direct radionuclide cystography(DRC) for evaluating the presence of VUR Results ① Of 48 children with APN, 29 2%(14/48) had renal scarring, and also 47 9%(23/48) patients and 44 8%(30/67) involved kidneys had VUR ② The incidence(85 7%) of VUR in patients with renal scarring was significantly higher than that(32 4%)in patients without scarring( P <0 01) The incidence(88 2%) of VUR in kidneys with scarring was also higher than that(30 0%) in kidneys without scarring( P <0 01) ③ Of 30 kidneys with VUR, the incidence of scarring was 73 3 % in kidneys with severe reflux, but was 11 5% in kidneys without reflux, or with mild or moderate reflux( P <0 01) Conclusions The association between VUR and scarring is documented The VUR may be one of the risk factors in prediposing the post pyelonephritis to renal scarring DRC is a sensitive, practical and much lower radiation exposure technique for detecting VUR and especially suitable for children
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2002年第4期217-219,共3页
Chinese Journal of Nuclear Medicine
