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尿道下裂病因学研究进展
贺厚光X 综述 张炜 审校
【摘要】 尿道下裂是小儿泌尿系统最常见的畸形之一,近年发病率呈上升趋势。为了从病因学上
来预防尿道下裂的发生和对尿道下裂的治疗提供指导,有必要重视病因学的研究。尿道下裂的病因至今不
明,是多种因素共同作用的结果。本文从内分泌因素、环境类雌激素破坏作用、表皮生长因子和遗传角度对
尿道下裂的病因学进行综述。
【关键词】 尿道下裂
[中图分类号]R696 [文献标识码] A [文章编号]100124594 (2004) 0320296204
尿道下裂是小儿泌尿生殖系统最常见的畸形之
一 ,国外发病率为 0. 3 %[1 ]。我国发生率低于 0.
1 %[2 ]。70年代至 80 年代欧洲尿道下裂呈不明原
因的增长 ,来自美国两个先天性畸形监测系统的资
料亦显示尿道下裂的发病率呈成倍增长[3 ]。国内外
学者对其治疗进行了大量研究 ,而病因学研究甚少 ,虽手术成功率较前有较大幅度的提高 ,并发症仍较
多 ,促使人们加强对病因学研究 ,期望从病因学上来
预防尿道下裂的发生及对尿道下裂的治疗提供指
导。本文就近年来病因学的研究进展作一综述。
using the previosly utilized urethral plate. Urology ,1999 ,54 ,724~726
5 Levent E ,Cankon G,Demokan E. Onlay island flap urethropasty :A com2
parative analysis of primary versus reoerative cases. Urology ,2003 ,61 ,216
~219
6 Warren T ,Snodgrass ,Michael T ,et al . Current technique of tubularized
incised plate hypospadias repair. Urology ,2002 ,60 ,157~162
7 Preston Smith. A comprehensive analysis of a tubularized incised plate hy2
pospadias repair. Urology ,2001 ,57 ,778~782
8 El2Sherbiny ,Abol2Enein ,Dawaba , et al . Treatment of urethral defects :
skin ,buccal or bladder mucosa ,tube or patch ? An experimental study in
dogs. J Urol ,2002 ,167 (5) ,2225~2228
9 Riccabona. Reconstruction or substitution of the pediatric urethra with
buccal mucosa : Indications , technical aspects , and results. Tech Urol ,1999 ,5 (3) ,133~138
10 Yerkes EB ,Adams MC ,Miller DA ,et al . Coronal cuff :a problem site for
buccal mucosal grafts. J Urol ,1999 ,162(4) ,1442~1444
11 Cigna RM,Chiaramonte C , Italiano F ,et al . Il trattamento delle compli2
canze nella chirurgia dell’ ipospadia :nuove prospettive.Minerva Urol Ne2
frol ,2002 ,54(2) ,107~111
12 Atala A. Experimental and clinical experience With Tissue Engineering
techniques for urethral reconstruction. Urol Clin North Am,2002 ,29 (2) ,485~492
13 Parnigotto PP , Gamba PG, Conconi MT , et al . Experimental defect in
rabbit urethra repaired with acellular aortic matrix. Urol Res ,2000 ,28
(1) ,46~51
14 Kassaby AW,Retik AB ,Yoo JJ ,et al . Urethral stricture repair with an off
the shelf collagen matrix. J Urol ,2003 ,169 (1) ,170~173
15 Atala A ,Guzman L ,Retik AB. A novel inert collagen matrix for hypospa2
dias repair. J Urol ,1999 ,162(3 Pt 2) ,1148~1151
16 Silver RI. What is the etiology of hypospadias ? A review of recent re2
search. Del Med J ,2000 ,72(8) ,343~347
17 Silver RI ,Rodriguez R ,Chang TS ,et al . In vitro fertilization is associated
with an increased risk of hypospadias. J Urol ,1999 ,161 (6) ,1954~
1957
18 Hussain N ,Chaghtai A ,Herndon CD ,et al . Hypospadias and early gesta2
tion growth restriction in infants. Pediatrics ,2002 ,109 (3) ,473~478
19 周李,梅骅,刘唐彬,等. 先天性尿道下裂与SRD5A2及SRY基因
突变关系研究.中华医学遗传学杂志,1999 ,16(5) ,311~314
20 Silver RI ,Russell DW. 5alpha2reductase type 2 mutations are present in
some boys with isolated hypospadias. J Urol ,1999 ,162(3 Pt 2) ,1142~
1145
21 Lin SK,Lee YH ,Pong HC ,et al . Prenatal diagnosis of a rare variant of
hypospadias and review of the literature. Ultrasound Obstet Gynecol ,2001 ,18 (6) ,678~680
22 Yoo JJ ,Soker S ,Lin LF ,et al . Direct in vivo gene transfer to urological
organs. J Urol ,1999 ,162 (3 Pt 2) ,1115~8
23 Fauza DO ,Fishman SJ ,Mehegan K,et al . Videofetoscopically assisted fe2
tal tissue engineering : skin replacement . J Pediatr Surg ,1998 ,33 (2) ,357~61
(收稿日期:2003211211)
692 国外医学泌尿系统分册 Urology and nephrology FMS ,May 2004 ,Vol . 24 NO. 3
作者单位:210019江苏,南京医科大学第一附属医院泌尿外科
? 1995-2006 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved. 现代研究表明 ,胚胎发育的第6周 ,尿生殖窦的
腹侧开始出现突起 ,形成尿生殖嵴 ,不久生殖嵴的两
侧出现生殖突 ,生殖嵴的尾侧形成尿道沟 ,两侧的隆
起为尿道襞 ......
贺厚光X 综述 张炜 审校
【摘要】 尿道下裂是小儿泌尿系统最常见的畸形之一,近年发病率呈上升趋势。为了从病因学上
来预防尿道下裂的发生和对尿道下裂的治疗提供指导,有必要重视病因学的研究。尿道下裂的病因至今不
明,是多种因素共同作用的结果。本文从内分泌因素、环境类雌激素破坏作用、表皮生长因子和遗传角度对
尿道下裂的病因学进行综述。
【关键词】 尿道下裂
[中图分类号]R696 [文献标识码] A [文章编号]100124594 (2004) 0320296204
尿道下裂是小儿泌尿生殖系统最常见的畸形之
一 ,国外发病率为 0. 3 %[1 ]。我国发生率低于 0.
1 %[2 ]。70年代至 80 年代欧洲尿道下裂呈不明原
因的增长 ,来自美国两个先天性畸形监测系统的资
料亦显示尿道下裂的发病率呈成倍增长[3 ]。国内外
学者对其治疗进行了大量研究 ,而病因学研究甚少 ,虽手术成功率较前有较大幅度的提高 ,并发症仍较
多 ,促使人们加强对病因学研究 ,期望从病因学上来
预防尿道下裂的发生及对尿道下裂的治疗提供指
导。本文就近年来病因学的研究进展作一综述。
using the previosly utilized urethral plate. Urology ,1999 ,54 ,724~726
5 Levent E ,Cankon G,Demokan E. Onlay island flap urethropasty :A com2
parative analysis of primary versus reoerative cases. Urology ,2003 ,61 ,216
~219
6 Warren T ,Snodgrass ,Michael T ,et al . Current technique of tubularized
incised plate hypospadias repair. Urology ,2002 ,60 ,157~162
7 Preston Smith. A comprehensive analysis of a tubularized incised plate hy2
pospadias repair. Urology ,2001 ,57 ,778~782
8 El2Sherbiny ,Abol2Enein ,Dawaba , et al . Treatment of urethral defects :
skin ,buccal or bladder mucosa ,tube or patch ? An experimental study in
dogs. J Urol ,2002 ,167 (5) ,2225~2228
9 Riccabona. Reconstruction or substitution of the pediatric urethra with
buccal mucosa : Indications , technical aspects , and results. Tech Urol ,1999 ,5 (3) ,133~138
10 Yerkes EB ,Adams MC ,Miller DA ,et al . Coronal cuff :a problem site for
buccal mucosal grafts. J Urol ,1999 ,162(4) ,1442~1444
11 Cigna RM,Chiaramonte C , Italiano F ,et al . Il trattamento delle compli2
canze nella chirurgia dell’ ipospadia :nuove prospettive.Minerva Urol Ne2
frol ,2002 ,54(2) ,107~111
12 Atala A. Experimental and clinical experience With Tissue Engineering
techniques for urethral reconstruction. Urol Clin North Am,2002 ,29 (2) ,485~492
13 Parnigotto PP , Gamba PG, Conconi MT , et al . Experimental defect in
rabbit urethra repaired with acellular aortic matrix. Urol Res ,2000 ,28
(1) ,46~51
14 Kassaby AW,Retik AB ,Yoo JJ ,et al . Urethral stricture repair with an off
the shelf collagen matrix. J Urol ,2003 ,169 (1) ,170~173
15 Atala A ,Guzman L ,Retik AB. A novel inert collagen matrix for hypospa2
dias repair. J Urol ,1999 ,162(3 Pt 2) ,1148~1151
16 Silver RI. What is the etiology of hypospadias ? A review of recent re2
search. Del Med J ,2000 ,72(8) ,343~347
17 Silver RI ,Rodriguez R ,Chang TS ,et al . In vitro fertilization is associated
with an increased risk of hypospadias. J Urol ,1999 ,161 (6) ,1954~
1957
18 Hussain N ,Chaghtai A ,Herndon CD ,et al . Hypospadias and early gesta2
tion growth restriction in infants. Pediatrics ,2002 ,109 (3) ,473~478
19 周李,梅骅,刘唐彬,等. 先天性尿道下裂与SRD5A2及SRY基因
突变关系研究.中华医学遗传学杂志,1999 ,16(5) ,311~314
20 Silver RI ,Russell DW. 5alpha2reductase type 2 mutations are present in
some boys with isolated hypospadias. J Urol ,1999 ,162(3 Pt 2) ,1142~
1145
21 Lin SK,Lee YH ,Pong HC ,et al . Prenatal diagnosis of a rare variant of
hypospadias and review of the literature. Ultrasound Obstet Gynecol ,2001 ,18 (6) ,678~680
22 Yoo JJ ,Soker S ,Lin LF ,et al . Direct in vivo gene transfer to urological
organs. J Urol ,1999 ,162 (3 Pt 2) ,1115~8
23 Fauza DO ,Fishman SJ ,Mehegan K,et al . Videofetoscopically assisted fe2
tal tissue engineering : skin replacement . J Pediatr Surg ,1998 ,33 (2) ,357~61
(收稿日期:2003211211)
692 国外医学泌尿系统分册 Urology and nephrology FMS ,May 2004 ,Vol . 24 NO. 3
作者单位:210019江苏,南京医科大学第一附属医院泌尿外科
? 1995-2006 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved. 现代研究表明 ,胚胎发育的第6周 ,尿生殖窦的
腹侧开始出现突起 ,形成尿生殖嵴 ,不久生殖嵴的两
侧出现生殖突 ,生殖嵴的尾侧形成尿道沟 ,两侧的隆
起为尿道襞 ......
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