临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (10): 768-774.doi: 10.12372/jcp.2025.25e0512

• 论著 • 上一篇    下一篇

婴儿慢性肾脏病筛查效果分析:基于江苏省启东市1 988名婴儿前瞻性研究结果

吴娟娟1,*, 刘天薏2,*, 洪莎2,*, 沈逸雯2, 王华1, 龚玲1, 霍云凤1, 张瀛丹1, 张琳琳1, 张伟2, 刘娇娇2, 沈茜2, 施兴华1, 沈军1, 仇万山1,3(), 翟亦晖2(), 徐虹2()   

  1. 1.启东市妇幼保健院/复旦大学附属儿科医院启东分院(江苏启东 226200)
    2.复旦大学附属儿科医院 上海市肾脏发育和儿童肾脏病研究中心(上海 201102)
    3.复旦大学附属中山医院儿科中心(上海 200032)
  • 收稿日期:2025-05-08 录用日期:2025-08-11 出版日期:2025-10-15 发布日期:2025-09-29
  • 通讯作者: 仇万山,翟亦晖,徐虹 E-mail:wanshanqiu@163.com;marinezyh@163.com;hxu@shmu.edu.cn
  • 作者简介:第一联系人:* 具有同等贡献
  • 基金资助:
    南通市自然科学基金和社会民生科技计划(指导性)项目(MSZ2023219);“十四五”国家重点研发计划项目(2021YFC2500202)

Analysis of the screening effect of chronic kidney disease in infants: based on the results of a prospective study of 1988 infants in Qidong, Jiangsu Province

WU Juanjuan1,*, LIU Tianyi2,*, HONG Sha2,*, SHEN Yiwen2, WANG Hua1, GONG Ling1, HUO Yunfeng1, ZHANG Yingdan1, ZHANG Linlin1, ZHANG Wei2, LIU Jiaojiao2, SHEN Qian2, SHI Xinghua1, SHEN Jun1, QIU Wanshan1,3(), ZHAI Yihui2(), XU Hong2()   

  1. 1. Qidong Women’s and Children’s Health Hospital/Children’s Hospital of Fudan University at Qidong, Qidong 226200, Jiangsu, China
    2. Children’s Hospital of Fudan University, Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai 201102, China
    3. Department of Pediatrics, Zhongshan Hospital of Fudan University, Shanghai 200032, China
  • Received:2025-05-08 Accepted:2025-08-11 Published:2025-10-15 Online:2025-09-29
  • Contact: QIU Wanshan, ZHAI Yihui, XU Hong E-mail:wanshanqiu@163.com;marinezyh@163.com;hxu@shmu.edu.cn

摘要:

目的 筛查启东市婴儿肾脏病的发生情况,评估早期筛查及干预的效果,探索儿童慢性肾脏病(CKD)的早期筛查模式。方法 建立前瞻性队列,对2022年出生并接受儿童健康体检的启东市0~1岁婴儿进行尿液试纸和泌尿系统超声的双筛查,对尿液初筛异常者进行复筛,对超声筛查异常者进行随访。通过问卷调查家长对儿童肾脏病的知晓情况,采用卡方检验评估家长学历与知晓率相关性。结果 共纳入1 988名婴儿,中位年龄为1.10(0.73~3.20)个月,男性988名(49.7%)。完成尿液筛查1 933名(97.2%),初筛检出异常180例(9.3%),以尿白细胞增多为最常见,复筛异常率0.5%。完成超声筛查1 958名(98.5%),检出异常231例(11.8%),其中先天性肾脏和尿路畸形195例(10.0%),以单纯性肾盂扩张为主(轻度140例、中度9例、重度2例),其次为重复肾/双肾盂、单肾小/双肾不等大、肾囊肿和输尿管末端囊肿。此外检出25例肾结晶和10例双肾回声增强。1 903名婴儿同时完成了尿液试纸和泌尿系统超声双筛查,双筛查异常者17例(0.89%)。回收儿童肾脏病认知问卷1 809份(回收率91.0%),家长对儿童肾脏病的知晓率为11.2%。父母学历为大专及以上者,其儿童肾脏病知晓率显著高于学历较低者(P<0.05)。有2例重度肾积水患儿经筛查早期确诊,获得及时的手术干预,预后良好。结论 生后早期尿液试纸和泌尿系统超声筛查有助于早期发现儿童CKD,可为临床早期、有效干预提供重要依据。

关键词: 泌尿系统超声筛查, 尿液试纸筛查, 慢性肾脏病, 婴儿

Abstract:

Objective To investigate the incidence of kidney diseases for children in Qidong, evaluate the efficacy of early screening and intervention, and explore a feasible early screening model for pediatric chronic kidney diseases (CKD). Methods A prospective cohort was established, and children (0-1 year old) born in 2022 who underwent child health examinations at Qidong Women’s and Children’s Health Hospital were enrolled. Dual screening (urinary system ultrasound and urine dipstick screening) was performed. Infants with abnormal results in initial urine dipstick were repeat screened, and those with abnormalities found in the ultrasound screening were followed up. The questionnaire was used to assess parental awareness of pediatric kidney diseases, and the association between parents’ educational level and the awareness were analyzed using the Chi-square test. Results A total of 1 988 infants were included, with a median age of 1.10 (0.73-3.20) months, including 988 boys (49.7%). Ultrasound screening was completed for 1958 individuals (98.5%), and 231 abnormal cases (11.8%) were detected. Among them, 195 cases (10.0%) were congenital anomalies of the kidney and urinary tract, primarily isolated renal pelvis dilation (140 mild, 9 moderate, and 2 severe cases), followed by duplex kidney or duplicated renal pelvis, unilateral small kidney or bilateral kidneys of unequal size, renal cysts, and distal ureteral cysts. Additionally, 25 cases of renal crystal and 10 cases of increased echogenicity of both kidneys were detected. A total of 1933 individuals (97.2%) completed urine dipstick screening. Abnormalities were detected in 180 cases (9.3%) during the initial screening, with increased white blood cells in urine being the most common. The abnormal rate of re-screening was 0.5%. A total of 1903 infants completed dual screening. Among them, 17 cases (0.89%) had abnormal results in both screenings. A total of 1809 parental questionnaires on pediatric kidney diseases awareness were collected (response rate 91.0%), with an awareness rate of 11.2%. Parents with an educational level of college or above had a significantly higher awareness rate compared to those with lower education levels (P<0.05). Two cases of severe hydronephrosis were identified through early screening and were promptly treated with surgical intervention, with favorable prognoses achieved. Conclusions Early postnatal urinary system ultrasound and urine dipstick screening facilitate the early detection of pediatric kidney diseases, providing a crucial evidence for timely and effective clinical intervention.

Key words: urinary system ultrasound screening, urine dipstick screening, chronic kidney disease, infant

中图分类号: 

  • R72