三聚氰胺污染奶粉致婴幼儿泌尿系统结石病例的流行病学特征分析

Epidemiological Feature on Urolithiasis of Infants Owing to Powdered Milk Tainted with Melamine

目的全面了解食用受三聚氰胺污染的婴幼儿奶粉致婴幼儿泌尿系统结石的流行病学特征。方法用统一的个案调查表,对确诊患儿的监护人进行问卷调查。结果调查11900例患儿,男、女性别比为1.38:1。平均年龄21月龄。分布在全省14个市(州)的86个县(市、区),仅有1个县(康县)无病例报告;病例以武威、白银、天水、平凉、庆阳、张掖、兰州和金昌等8市为多,占全部调查病例的88.2%;病例数在200例以上的县(区)21个,占全部调查病例的70.6%。有奶粉喂养史的11826例,占99.4%;有三鹿奶粉喂养史的10672例,占89.7%。患儿截至发病累计食用三鹿奶粉量平均为17.7kg。病例以肾结石为多,占87.8%;其次为肾积水,占23.3%;输尿管等结石较少,占3.5%。结论三聚氰胺污染奶粉致婴幼儿泌尿系统结石的男、女性别比较接近出生人口性别比,表现出明显的地区聚集性,以对食用奶粉依赖性和高暴露年龄组儿童的上尿路结石为主,其流行病学特征与文献报告的一般小儿尿石症不同。

OBJECTIVE Analysis epidemiological distributing characteristics of urinary system calculus for infants feeding powdered milk contaminated by melamine.METHODS Survey gender,age,dwelling place,feeding history by case questionnaire of infants keeper,and urinary system organic were examined by B-ultrasound.RESULTS Among 11 900 urinary system calculus cases from 86 counties of Gansu,21 counties had more than 200 cases,the cases was 70.6%.The male-to-female ratio of was 1.38：1,the average age was 21-month-old.the cases who had milk powder feeding history was 99.4%（11 826/11 900）,who had Sanlu milk powder feeding history was 89.7%（10 672/11 900）.Average cumulative consumption of Sanlu milk powder was 17.7 kg before finding urinary system calculus,renal calculus was 87.8%.CONCLUSION The male-to-female ratio of the urinary system calculus is close to sex ratio at birth,which caused by melamine contaminated milk powder,the urinary system calculus appeared area clustering,calculus were largely in upper urinary tract of the infants who had powdered milk dependence and high exposure groups,the epidemiological characteristics is different from the general pediatric urolithiasis reported.