三聚氰胺致泌尿系结石患儿尿肾功测定的意义

Significance of determination of kidney function through urine in infants who ingested melamine-tainted milk powder

目的测定因食用含三聚氰胺超标奶粉致泌尿系结石的患儿尿肾功,探讨三聚氰胺对肾小球、肾小管功能的影响。方法对2008年4月2008年12月在甘肃省20家医院进行＂三聚氰胺致婴幼儿泌尿系结石调查＂中筛查阳性的180例婴幼儿尿液,进行尿微量白蛋白（UMA）、β2-微球蛋白（β2-MG）、α1-微球蛋白（α1-MG）的定量测定,观察三聚氰胺对肾小球、肾小管功能的损害情况,以及损害程度与结石部位、婴幼儿性别、年龄、食用奶粉时间的相关性。结果 180例患儿中有31例患儿出现UMA异常[（10.79±19.19）μg/mL],19例患儿出现β2-MG异常[（65.19±137.83）μg/mL],而α1-MG未见异常[（0.41±0.34）μg/mL]。统计结果显示,UMA异常存在统计学差异（P〈0.05）,β2-MG、α1-MG无统计学差异（P〉0.05）;UMA、β2-MG异常与奶粉使用率存在正相关。结论食用三聚氰胺污染奶粉对小儿肾小球、肾小管功能有损害,且年龄越小、服用三聚氰胺污染奶粉时间越长其损害程度越重。

Objective To investigate kidney function changes due to consumption of milk powder containing excessive melamine and to discuss the influence of melamine on kidney glomerular and tubular functions.Methods We studied 180 infants with positive urine detected between April and December,2008 in the action of ＂The Survey of Melamine-induced Urinary Stones in Infants＂ in Gansu Province.Urinary albumin（UMA）,β2-microglobulin（β2-MG） and α1-microglobulin（α1-MG） were determined quantitatively so as to observe whether melamine resulted in long-term damage to the kidney as well as correlation of the damage with stone site,infant gender,age and time of milk consumption.Results The results showed that among the 180 children,there were 31 cases of abnormal UMA [（10.79±19.19）μg/mL] and 19 cases of abnormal β2-MG [（65.19±137.83）μg/mL],but α1-MG [（0.41±0.34）μg/mL] was normal.The statistical data showed that UMA abnormality had significant differences（P〈0.05）,but not β2-MG or α1-MG（P〉0.05）.Abnormal UMA and β2-MG were positively correlated with milk powder consumption.Conclusion Melamine damages kidney glomerular and tubular functions.The younger age and longer consumption of melamine-contaminated milk powder,the more serious damage is caused to the infants’ kidney function.