食用含三聚氰胺奶粉致婴幼儿泌尿系统结石的危险因素

Risk Factors of Urolithiasis in Infants and Young Children with History of Consumption of Melamine-Contaminated Milk Powder

目的探讨食用含三聚氰胺奶粉致婴幼儿泌尿系统结石的危险因素。方法2008年本院在对食用含三聚氰胺奶粉婴幼儿进行泌尿系统结石筛查的基础上,对242例泌尿系统结石患儿[病例组。男149例,女93例;年龄(19.092±9.903)个月;食用三聚氰胺污染奶粉时间(14.960±9.055)个月]和242例无尿路结石的婴幼儿[对照组。男149例,女93例;年龄(18.682±9.558)个月;食用三聚氰胺污染奶粉时间(15.240±9.356)个月]进行病例对照研究,以年龄、性别、城乡区域、喂养方式相同作为配比条件。从既往研究和已有文献中选取7项可能影响泌尿系统结石形成的相关危险因素,采用SPSS12.0软件对数据进行χ2检验、单因素及多因素条件Logistic回归分析。结果食用含三聚氰胺高的三鹿奶粉患儿165例,其中结石患儿151例,占总数的62.40%;食用非三鹿奶粉319例,泌尿系结石91例,占37.60%。单因素分析显示,在选取的7种危险因素中,仅食用不同品牌含三聚氰胺奶粉、平均每日饮水量在病例组与对照组间比较差异有统计学意义(Pa<0.01),但饮用水来源、出汗量、补充钙剂、奶粉冲服方式和奶粉食用时间比较差异无统计学意义(Pa>0.05)。多因素分析证实食用含三聚氰胺高的奶粉和饮水量不足与婴幼儿泌尿系统结石显著相关,其OR值(95%可信区间)分别为26.878(14.729～49.049)和2.077(1.108～3.891)。结论食用三聚氰胺含量较高的奶粉和饮水量不足是婴幼儿泌尿系统结石形成的主要危险因素,预防婴幼儿泌尿系统结石最有效、最安全和最廉价的方法为多饮水。

Objective To explore the risk factors of urolithiasis in infants and young children with the history, of consumption of melamine - contaminated milk powder in Jiangxi province. Methods On the basis of screening infantile urolithiasis among infants and young children with the history of consumption of melamine - contaminated milk powder in 2008 ,a 1 ： 1 paired case - control study was conducted with 242 cases of urinary system stones,and 242 controls matched in age, sex, residential area and feeding manner. There were 149 boys and 93 girls in each group. The age and the time of feeding melamine - contaminated milk were （ 19. 092 ± 9. 903 ） months vs （ 18. 682 ± 9. 558 ） months and（ 14. 960 ± 9. 055 ） months vs （ 15. 240 ± 9. 356） months among urolithiasis group and control group,respectively. The 7 possible risk factors of the urolithiasis were chosen according to our previous studies and bibliographies. Data were analyzed by using SPSS 12.0 software forx2 test,univariate and multivariate conditional Logistic regression analysis. Results There were 151 infants with urolithiasis out of 165 infants with the history of consumption of Sanlu milk powder containing high level of melamine,accounting for 62.40% of the total,whereas there were merely 91 eases suffering from urinary calculus among 319 cases with the history of consumption of milk powder of other brands, taking up 37.60% of the total,which showed that there was a significant statistical difference between the 2 groups（ P 〈 0. 05 ）. Univariate analysis revealed that the melamine -contaminated milk powder and the average daily water intake had significant differences between the 2 groups （P 〈 0. 01 ） ,but there were no statistical differences in the sources of drinking water,the amount of sweat,supplement calcium,the way milk powder dilution and the time of milk consumption between 2 groups（P 〉0.05 ）. Multivariable analysis confirmed further that the melamine - contaminated milk powder of Sanlu brand and the average daily water intake were significantly related to urolithiasis in infants and young chil- dren,and their 0R（95% confidence interval）were 26. 878 （ 14. 729 - 49. 049 ）, 2. 077 （ 1. 108 - 3. 891 ）, respectively. Conclusions The consumption of melamine - contaminated milk powder and drinking less water were the key risk factors contributing to the urolithiasis in infants and young children. Drinking more water is the most effective, safest and cheapest way to prevent urinary calculus in infants and young children.