肾外结核尿检结果异常患儿临床特点分析

Clinical features analysis of children with extra-renal tuberculosis infection combined with abnormal findings in urinalysis

目的探讨肾外结核尿检结果异常患儿的临床特点。方法回顾性分析新乡医学院第一附属医院2014年1~12月收治的270例肾外结核患儿的临床资料,总结肾外结核尿检异常患儿的临床特点。结果 270例肾外结核患儿中尿检异常者57例(21.1%),其中仅蛋白尿者27例(47.4%),仅血尿者20例(35.1%),蛋白尿合并血尿者10例(17.5%)。入院前未应用抗结核药物患儿尿检异常检出率与入院前应用抗结核药物患儿比较差异无统计学意义(χ~2=1.354,P>0.05)。肺合并骨关节结核、肺合并肝脏和腹壁结核、肺合并脑和骨关节结核患儿尿检异常检出率最高(均为100%),肺和(或)胸膜结核患者尿检异常检出率最低(14.5%)。2个及2个以上部位结核感染者尿检异常检出率高于单部位感染者(χ~2=12.952,P<0.05)。57例肾外结核尿检异常患儿男女比例1.28∶1,发病年龄高峰在17~18岁(61.4%);发病部位以肺和(或)胸膜最多见(54.4%);临床表现主要以结核中毒症状为主,泌尿系统症状表现不明显。结论肾外结核尿检异常患儿临床表现以蛋白尿、血尿为主;对于肾外结核感染部位较多的青少年患儿,应高度重视肾累及的可能。

Objective To analyze the clinical features of children with renal-extra tuberculosis infection combined with urinary abnormalities.Methods The clinical data of 270 children with extra-renal tuberculosis from January to December of 2014 in the First Affiliated Hospital of Xinxiang Medical University were analyzed retrospectively.The clinical features of children with extra-renal tuberculosis infection combined with abnormal findings in urinalysis were analyzed.Results Fifty-seven children with urinary abnormalities were detected from 270 children with extra-renal tuberculosis.And the urinary abnormalities detection rate was 21.1%involving simple proteinuria in 27 cases（47.4%）,simple hematuria in 20 cases（35.1%）,proteinuria and hematuria in 10 cases（17.5%）.There was no significant difference in the urinary abnormalities detection rate between children who did not take anti-tuberculosis drugs before admission and those who took anti-tuberculosis drugs before hospitalization（ χ^2=1.354, P 〉0.05）.The urinary abnormalities detection rate was the highest in lung combined with bone and joint tuberculosis,lung combined with liver,abdominal tuberculosis and lung combined with brain,bone and joint tuberculosis patients（all 100%）,and the urinary abnormalities detection rate of lung and/or pleural tuberculosis patients was the lowest （14.5%）.The detection rate of abnormal urine test in children with 2 or more tuberculosis infection sites was higher than that in single site （ χ^2=12.952, P 〈0.05）.The male to female ratio in 57 urine abnormalities children with extra-renal tuberculosis was 1.28 GA6FA 1.The peak age of onset was 17-18 years old（61.4%）.The lung and/or pleural tuberculosis was the most common sites （54.4%）.The clinical manifestations were mainly tuberculosis poisoning symptoms,and however,the symptoms of urinary system were not obvious.Conclusion The renal involvement of children with extra-renal tuberculosis is mainly characterized by proteinuria and hematuria.For adolescent patients with more extra-renal tuberculosis infection sites,the possibility of kidney involvement should be weighed carefully by clinicians.