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一、概述膀胱输尿管反流(vescioureteral reflux,VUR)是指由于各种原因引起的尿液自膀胱逆流入输尿管、肾盂。原发性VUR是由于膀胱输尿管连接部瓣膜作用不全而导致的尿液逆流,是先天性病变;继发病变多由于反复尿路感染、下尿路梗阻、创伤等。儿童发病原因多为原发性,一岁以内是VUR的易患阶段,多数病例在尿路感染后被诊断[1-4]。由于反流的存在,可致尿路感染的风险增高,甚至可致反流性肾病、肾功能不全,最终致终末期肾病及瘢痕肾。有报道患尿路感染(urinary tract infection,UTI)的患儿有约20%～40%合并有VUR,在儿童中VUR的发病率约1%～2%[5-6]。VUR有家族性及遗传倾向,是一种多基因遗传病[7-8],由于性别上生理结构差异和年龄的不同,男孩在婴儿期,女孩在儿童期呈现双峰型发病高峰[7,9]。现在的研究对VUR与慢性肾脏疾病的关系提出质疑[10-12],以往报
First, an overview vesicoureteral reflux (vescioureteral reflux, VUR) is due to various causes of urine from the bladder into the ureter, renal pelvis. Primary VUR is due to incomplete urinary bladder valve connection caused by urinary reflux, is congenital lesions; secondary lesions due to repeated urinary tract infections, lower urinary tract obstruction, trauma and so on. Most of the causes of children are primary, within one year of VUR susceptibility stage, most cases were diagnosed after urinary tract infection [1-4]. Due to the presence of reflux, can cause increased risk of urinary tract infection, and even can cause reflux nephropathy, renal insufficiency, and ultimately cause end-stage renal disease and scarring kidney. It has been reported that about 20% to 40% of children with urinary tract infection (UTI) have VUR combined, and the incidence of VUR in children is about 1% to 2% [5-6]. VUR has a familial and genetic predisposition and is a polygenic disease [7-8]. Due to differences in gender and age, boys have a bimodal peak in infancy and infancy [7, 9]. The present study questioned the relationship between VUR and chronic kidney disease [10-12]. Previously reported