再谈儿童血尿的诊断程序

    Diagnostic procedure of hematuria in children

    • 摘要: 血尿是儿童最常见的尿检异常之一,也是儿童多种肾小球疾病的早期表现之一。当然,除了肾脏疾病,其他多种非肾脏疾病也可能引起血尿。因此,对于血尿的评估、诊断和处理,是儿科肾脏专业医师的必备技能。对于血尿的诊断,目前国内外已经有标准的程序即定性、定位和定因。笔者现就血尿的定义、分类和诊断,结合国内外目前现状,提出自己的一些个人建议,特别指出孤立性血尿仅指持续性镜下血尿,而肉眼血尿应归属于血尿和蛋白的范畴,孤立性血尿的最常见病因为薄基底膜肾病,明确或除外诊断首选基因检测而不是肾活检。

       

      Abstract: As one of the most common urinary abnormalities, hematuria is one of early manifestations of various glomerular diseases in children. Beside kidney diseases, other diseases may also cause hematuria. Therefore proper assessments, diagnoses and treatments of hematuria have remained essential skills for pediatric nephrologists. For its definite diagnosis, there are standard procedures of qualitative assays, localization studies and cause determinations. The author proposed some personal suggestions on the definition, classification and diagnosis of hematuria. It also emphasized that isolated hematuria only refers to continuous microscopic hematuria while gross hematuria belongs to the category of hematuria and protein. For isolated continuous microscopic hematuria, thin basement membrane nephropathy is the most common cause. Instead of renal biopsy, gene detection is preferred for diagnosis.

       

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