兰州市10 795名中小学生尿筛查及随访情况分析

Urinary screening and follow-up analysis of 10 795 school children in Lanzhou city

目的了解中小学生尿异常情况,探讨儿童尿液筛查的意义。方法 2012年4月至2013年10月,以尿试纸法对兰州地区10 795名中小学生进行晨尿筛查,初次尿液筛查阳性者2周后复查,两次阳性者当地医院行尿常规检查。结果初次筛查发现尿潜血1 653例(15.31%),尿蛋白阳性516例(4.78%),潜血合并蛋白尿112例(1.04%),白细胞尿743例(6.88%);2周后复查潜血阳性815例(7.55%),尿蛋白阳性230例(2.13%),潜血合并蛋白尿74例(0.69%),白细胞尿271例(2.51%)。其中455例行尿常规检查,白细胞尿32例,血尿147例,蛋白尿23例,蛋白尿伴血尿13例,最终随访发现慢性肾疾病12例。初中生血尿、蛋白尿比例高于小学生。结论儿童尿液筛查是发现无症状性肾病及泌尿系统感染的有效办法,且需要加强随访。

Objective To investigate the prevalence of urine abnormalities for school children in Lanzhou and evaluate the signiifcance of urine screening. Methods During 2012-2013, urine from 10795 students were collected, and screened by urine reagent paper. Two weeks later, repeated screening was conducted in those who had abnormal result in the ifrst screening. Children with both results being abnormal were submitted to urine routine tests in local hospitals. Results In the ifrst screening of school children, 1653 （15.31%） children were urinary occult blood positive, 516 （4.78%） had urinary protein, 112 （1.04%） had occult blood with proteinuri and 743 （6.88%） had white cells in urine. In the second urine screening, the positive rate of occult blood was 7.55%（815 ）, urinary protein was 2.13%（230）, occult blood with proteinuria was 0.69%（74） and white cells in urine was 2.51%（271）. Four hundred and iffty-ifve students in 1359 were submitted to urine routine tests. Thirty-two children had pyuria, 147 had hematuria, 23 had proteinuria and 13 had occult blood with proteinuria. Thirteen cases of chronic kidney disease were found in the follow-up. The incidence of urine abnormalities was signiifcantly higher in junior middle school than in primary school. Conclusions Urine screening is an effective way to ifnd asymptomatic kidney disease and urinary tract infection. Follow-up should be strengthened.