食用含三聚氰胺奶粉婴幼儿泌尿系统结石的危险因素分析

目的探讨食用含三聚氰胺奶粉的婴幼儿发生泌尿系结石的危险因素。方法收集2008年9月14日～2009年1月6日在兰州大学第二医院进行免费筛查的食用含三聚氰胺奶粉的婴幼儿病历，根据发生结石的病例数按1：1比例从无泌尿系结石的婴幼儿中随机抽取对照组，采用logistic回归模型对泌尿系结石的危险因素进行单冈素和多因素分析。结果结石组647例，对照组647例，男678例，女616例，平均年龄19．27月。食用高三聚氰胺含量的二三鹿奶粉婴幼儿发生泌尿系结石的OR为6．09（P〈0．01），其中婴儿性别为男、人工喂养的OR值分别为1．39（P〈0．01）和1．61（P〈0．01）。随着年龄增长发生结石的风险逐渐下降，〈6月、6月-、12月～婴幼儿发生结石的OR值分别是5．23（P〈0．01）、2．73（P〈0．01）、1．60（P〈0．01）。随着食用含三聚氰胺奶粉时间的延长，发生结石的风险逐渐增加。食用含i聚氰胺奶粉3个月-、6个月～、12个月～婴幼儿发生结石的OR值分别是2．10（P〈0．01）、2．81（P〈0．01）、4．75（P〈0．01）。结论食用高三聚氰胺含量奶粉（三鹿奶粉）、人工喂养和男性是婴幼儿发生泌尿系结石的危险因素，食用含三聚氰胺奶粉时间越长、年龄越小，发生泌尿系结石的风险越高。

The Risk Factors of Melamine Associated Urolithiasis in Infants: A Single-Center Retrospective Study

Objective To investigate the risk factors of infantile urolithiasis resulted from taking milk powder with melamine. Methods The clinical data of infant and young children who took free-screening for melamine associated urolithiasis in the Lanzhou University Second Hospital from September 14% 2008 to lanuary 6% 2009 were collected, while the infants without urolithiasis in the same number as those with urolithiasis were also randomly collected into the control group. Then both univariate and multivariate analyses were performed with a logistic regression model to assess the independent risk factors for urolithiasis. Results Of the screened children, 647 children were included in the urolithiasis group and 647 were in the control group. There were 678 boys and 616 girls with an average age of 19.27 months. The results of logistic regression analysis showed that, the children fed with Sanlu powdered infant milk formula which contained a high level of melamine were more likely to suffer from urolithiasis than those took other melamine-contaminated formula （OR=6.09, P〈0.01）; boys were more than girls （OR= 1.39, P〈0.01）, and children fed with formula alone were more than those fed with both formula and breast milk （OR= 1.61, P〈0.0 1）. The risk of urolithiasis decreased gradually with age, and the OR value of children in age of smaller than 6 months, 6 to 12 months, 12 to 24 months were 5.23 （P〈0.01）, 2.73 （P〈0.01）, and 1.60 （P〈0.01）, respectively. The risk of urolithiasis increased gradually with the time lengthening of taking melamine-contaminated formula, and the OR value of children who had took melamine-contaminated formula for 3 to 6 months, 6 to 12 months and more than or equal to 12 months were 2.10 （P〈0.01）, 2.81 （P〈0.01）, and 4.75 （P〈0.01）, respectively. Conclusion It shows that feeding with high melamine infant formula （Sanlu powdered infant milk formula）, artificial feeding and male children are the risk factors of infantile urolithiasis. Additionally, the risk of urolithiasis decreases with a~e and increases with time of formula feeding