维生素A有预防急性肾盂肾炎后瘢痕形成的作用
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【摘要】目的 评估维生素A在预防儿童急性肾盂肾炎后肾瘢痕形成中的作用。方法 挑选经临床及二巯基丁酸(DMSA)肾显像扫描确诊的急性肾盂肾炎的儿童进行临床试验研究，86例患者被随机分为两组，实验组接受头孢曲松和维生素A治疗，对照组只接受头孢曲松治疗，疗程6个月。治疗前与6个月后，进行DMSA肾显像扫描，并比较两组之间的肾瘢痕形成及肾损伤的程度。结果 共有86例患者(男女比例为17:69)进入本研究，平均年龄为3.7±1.2岁，实验组维生素A的平均水平为67±21μg/dL，对照组为63±28μg/dL。实验前，两组间DMSA扫描肾损伤的程度无明显差异(P>0.05)，6个月后DMSA扫描结果显示，与对照组相比，实验组肾功能损伤及瘢痕形成的程度明显改善(P <0.01)。结论 维生素A可减少肾盂肾炎肾损伤及瘢痕形成的程度，可用于儿童急性肾盂肾炎的辅助治疗。
【关键词】肾盂肾炎 维生素A 肾脏瘢痕 DMSA肾扫描
中图分类号：R726.9 文献标识码：A 文章编号：1005-0515(2012)1-030-03
Vitamin A decreases renal scarring after acute pyelonephritis
Qin Dayong
(Department of Urology, Huangchuan County People's Hospital, Xinyang 465150, China)
【Abstract】Objective In order to evaluate the role of vitamin A in preventing renal scaring after acute pyelonephritis in children. Methods Selected the patients of acute pyelonephritis in children by clinical and dimercaptosuccinic acid (DMSA) renal scintigraphy scan in the clinical trials, 86 patients were randomly divided into two groups, study group received ceftriaxone and vitamin A and control group only received ceftriaxone for 6 months. DMSA renal scintigraphy was performed before the start of the treatment and 6 months later, and compared the degree of renal damage and renal scarring between the two groups. Results A total of 86 patients (male:female 17:69) enrolled in the study, and the average age of 3.7±1.2 years. The average level of vitamin A was 67±21 μg / dL in the study group, the control group was 63 ± 28 μg / dL. Before the experiment, DMSA renal scintigraphy was not significant difference between the two groups (P > 0.05), the results of DMSA scan after 6 months show that, compared with the control group, the degree of renal scarring and renal function were significant change in the study group (P <0.01). Conclusion Vitamin A was useful in decreasing the amount of the injury and scarring following the pyelonephritis, and can be used in conjunction with other treatments in the management of acute pyelonephritis in children.
【Key words】pyelonephritis Vitamin A renal scarring DMSA renal scintigraphy
泌尿系感染(UTI)是被认为是儿童最常见的感染之一，也是泌尿生殖系统最常见的感染。儿童泌尿系感染发生率女孩占3%-5%和男孩占1%，如果不及时诊断治疗，就可能会导致败血症或长期并发症的发生，如高血压，甚至慢性肾功能衰竭[1]。这些并发症主要发生于尿路感染后肾脏瘢痕形成的患者。肾脏瘢痕与重度膀胱输尿管返流和复发性肾盂肾炎的存在密切相关[2, 3] ......
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