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目的探讨兰州市0~6岁儿童尿液阳性检测结果影响因素,为儿童期慢性肾病的早期防治提供依据。方法整群抽取兰州市城关区10所托幼机构学龄前儿童,留取晨尿样本进行尿液常规检测,并进行体格检查和问卷调查,分析儿童生理特征、饮食状况、环境暴露及父母病史等因素与尿液检测结果的关联。结果前5位尿检测阳性结果依次为尿维生素C阳性421例(41.32%),尿白细胞阳性75例(7.36%),尿胆原阳性67例(6.58%),尿酮体阳性61例(5.99%),尿隐血阳性56例(5.50%)。多因素Logistic回归分析结果显示,含铅食品的摄入使得尿隐血阳性检出率增高(OR=5.04,95%CI=1.26~20.25);男童较女童尿白细胞阳性检出率低(OR=0.10,95%CI=0.05~0.22);<1岁组与4~6岁组相比尿维生素C阳性检出率低(OR=0.16,95%CI=0.06~0.42),2~3岁组与4~6岁组相比尿维生素C阳性检出率低(OR=0.70,95%CI=0.54~0.91);父母均有肾脏病史的儿童较父母均无肾脏病史的儿童尿维生素C阳性检出率高(OR=2.50,95%CI=1.58~3.97);男童较女童尿酮体阳性检出率高(OR=2.72,95%CI=1.40~5.29),BMI高者尿酮体阳性检出率高(OR=1.09,95%CI=1.01~1.17)。结论儿童的生理状况、饮食以及家族肾脏病史可能导致尿液异常。儿童应尽可能避免含铅食品的摄入、合理摄入营养素、保持适宜体重,关注女童泌尿系统的易感性对父母均有肾脏病史的儿童积极筛查尿液。
Objective To investigate the influencing factors of positive urine test results of children aged 0 ~ 6 years in Lanzhou City, and to provide evidence for early prevention and treatment of chronic kidney disease in childhood. Methods A total of 10 preschool children in kindergartens from Chengguan District, Lanzhou City were enrolled in this study. Morning urine samples were collected for urine routine examination. Physical examination and questionnaire survey were conducted to analyze children’s physiological characteristics, dietary status, environmental exposure and their parents’ medical history. Factors associated with urine test results. Results The positive results of urinalysis in the first five urine tests were as follows: 421 cases (41.32%) of urinary vitamin C positive, 75 cases (7.36%) of urinary white blood cells positive, 67 cases (6.58%) urolithiasis positive and 61 cases (5.99% Urine occult blood was positive in 56 cases (5.50%). Multivariate logistic regression analysis showed that the detection rate of urinary occult blood increased with the intake of lead-containing foods (OR = 5.04, 95% CI = 1.26-20.25); the prevalence of urinary leukocytes in boys was lower than that in girls (OR = 0.10, 95% CI = 0.05-0.22). The positive detection rate of urinary vitamin C in patients <1 year old was lower than that of 4 ~ 6 years old patients (OR = 0.16,95% CI = 0.06-0.42) Compared with 4 to 6 years old group, the positive rate of urinary vitamin C was lower (OR = 0.70, 95% CI = 0.54-0.91); children with both parents had a history of kidney disease than those whose parents had no history of kidney disease. (OR = 2.50, 95% CI = 1.58-3.97). The positive rate of urine ketone bodies was higher in boys than in girls (OR = 2.72,95% CI = 1.40-5.29) (OR = 1.09, 95% CI = 1.01-1.17). Conclusions Children’s physical condition, diet, and family history of kidney disease may cause abnormal urine. Children should try their best to avoid the intake of lead-containing foods, rationally absorb nutrients, maintain proper body weight, and pay attention to the urinary system susceptibility of girls. Urine should be actively screened in children with a history of kidney disease by both parents.