超声筛查三聚氰胺污染奶粉致婴幼儿泌尿系结石112例

目的通过超声筛查曾食用受三聚氰胺污染奶粉的婴幼儿泌尿系统，证实食用受三聚氰胺污染的食品可使人类特别是婴幼儿产生泌尿系结石。方法回顾性分析2008年9月至11月因食用受三聚氰胺污染奶粉在本院B超检查确诊为泌尿系结石的婴幼儿临床资料，分析其超声影像学特点。结果共筛查9224人次，确诊为婴幼儿泌尿系结石112例，占总筛查人数的1．21％；其中双肾结石21例，左肾结石46例，右肾结石44例；肾盂输尿管交界处7例，输尿管膀胱交界处5例；超声检查显示4mm左有结石中，31例呈彗星尾征，8mm以上结石中，2例后方声影不明显；随访确诊为结石的婴幼儿58例，发现11例为5mm左右结石，1例输尿管结石，1例8mm以上结石消失，5例结石变小或数量减少，4例结石发生位移。结论食用受三聚氰胺污染的食品可使人类特别是婴幼儿发生泌尿系结石；此类结石质地疏松，以小结石和泥沙样结石为主，累及范围较广。

Screening melamine related urinary calculus by ultrasound

Objective Via screening the urinary system of children fed with the melamine-contaminated milk products, we considered that Melamine can cause human kidney stones, especially in children. Methods Data of infant patients with urinary calculus due to melamine-contaminated milk products admitted to the Shanghai Children＇s Hospital of Fudan University were used to analyze the ultrasonic image characteristics. Results 9 224 children been screened by ultrasonic imaging, and 112 （1.21%） of them were diagnosed as urinary calculus. Among the 112 eases of calculus, 21 were dual kidney stones, 46 left kidney stones, and 44 right kidney stones, 7 eases were at the ureteropelvic junction,5 eases were at the ureterovesical junction. When the stone diameters were around 4 ram, the comet tail sign was shown in 31 eases by ultrasonic imaging, and when the diameters were larger than 8 ram, no evident sound shadow was observed in 2 calculus cases. Fallow-up surgery showed that in 58 calculus eases were followed-up for different duration, and 14 calculus eases （11 calculus eases around 5 mm,1 ureteral calculus ease and 1 calculus eases larger than 8 mm） could＇t been observed, 5 calculus eases were observed with change of number and size, 4 calculus eases were observed to change position. Conclusions Melamine-contaminated milk products may cause human urinary calculus, especially in children. The melamine related urinary calculus are observed to be loose and wider-scope, little and sand-like calculus are majority.