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中华临床医师杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 112 -116. doi: 10.3877/cma.j.issn.1674-0785.2023.02.002

临床研究

再看儿童孤立性镜下血尿的常见病因
王丽霞, 马丽娟, 张宏文()   
  1. 751000 银川,北京大学第一医院宁夏妇女儿童医院儿科
    751000 银川,北京大学第一医院宁夏妇女儿童医院儿科;100034 北京,北京大学第一医院儿科
  • 收稿日期:2021-12-31 出版日期:2023-02-15
  • 通信作者: 张宏文
  • 基金资助:
    宁夏儿童慢性肾脏病研究及监测管理项目(2021年健康宁夏行动建设项目)(2021-NW-092)

Analysis of etiology of isolated microscopic hematuria in children

Lixia Wang, Lijuan Ma, Hongwen Zhang()   

  1. Department of Pediatrics, Peking University First Hospital-Ningxia Women and Children's Hospital, Yinchuan 750001, China
    Department of Pediatrics, Peking University First Hospital-Ningxia Women and Children's Hospital, Yinchuan 750001, China; Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
  • Received:2021-12-31 Published:2023-02-15
  • Corresponding author: Hongwen Zhang
引用本文:

王丽霞, 马丽娟, 张宏文. 再看儿童孤立性镜下血尿的常见病因[J/OL]. 中华临床医师杂志(电子版), 2023, 17(02): 112-116.

Lixia Wang, Lijuan Ma, Hongwen Zhang. Analysis of etiology of isolated microscopic hematuria in children[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(02): 112-116.

目的

探讨儿童孤立性镜下血尿的常见病因和处理措施。

方法

纳入2014年1月1日至2018年12月31日北京大学第一医院儿科诊断明确的孤立性镜下血尿患儿,分析其临床特点和病因构成。

结果

5年间纳入研究孤立性镜下血尿患儿共320例,病因以肾小球疾病为主(86.25%,276/320),包括薄基底膜肾病、紫癜性肾炎、感染后肾小球肾炎和Alport综合征;非肾小球疾病少见(13.75%,44/320),包括高钙尿症/肾结石、左肾静脉扩张综合征、热性/运动性血尿、自身免疫性疾病、外伤和高血压。在所有病因中,以薄基底膜肾病最为常见,共199例(62.19%)。

结论

儿童孤立性镜下血尿最常见的病因是薄基底膜肾病,总体预后好,临床应该以定期随访和监测为主,避免过度检查和治疗。

Objective

To explore the etiology of childhood isolated microscopic hematuria in China.

Methods

Children with isolated microscopic hematuria diagnosed at our hospital from January 2014 to December 2018 were studied retrospectively to summary their clinical characteristics and final diagnosis.

Results

There were 320 cases of isolated microscopic hematuria. The major (86.25%, 276/320) causes were glomerular diseases, including thin basement membrane nephropathy, purpura nephritis, post-infectious glomerulonephritis and Alport syndrome, while the minor (13.75%, 44/320) causes were non-glomerular diseases, including hypercalciuria or renalcalculus, left renal vein entrapment syndrome, febrile or exercise hematuria, and autoimmune disease. Thin basement membrane nephropathy is the most common cause (62.19%).

Conclusion

Thin basement membrane nephropathy is the main cause of childhood isolated microscopic hematuria in China. The overall prognosis is good. Long-term follow-up and surveillance are more important and necessary than excessive examinations and treatments.

表1 320例孤立性镜下血尿患儿不同性别的病因构成[例(%)]
表2 320例孤立性镜下血尿患儿不同年龄组的病因构成[例(%)]
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