Outcome of sibling vesicoureteral reflux
Outcome of sibling vesicoureteral reflux
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DOI：
10.1016/s0022-5347(05)65450-x
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发表时间：
2002-01-01
影响因子：
6.6
通讯作者：
Brock, JW
中科院分区：
文献类型：
--
作者：
Parekh, DJ;Pope, JC;Brock, JW
目的：我们确定无症状兄弟姐妹反流患者的前瞻性筛查分析的有效性。材料和方法：对78例反流患者的兄弟姐妹进行评估，其中40例（51%）发生反流。评估其治愈率及手术干预的必要性。结果：40例患者发生膀胱输尿管反流，其中I级12例，II级33例，III级19例，IV级1例。超声无明显肾瘢痕，排尿膀胱输尿管造影无肾盂畸形。所有患者均采用预防性抗生素治疗。1例患者因突发性尿路感染需要手术矫正。对31例患者进行了随访，其中26例患者通过药物治疗完全消除了反流。4例患者反流减轻。在反流完全消除的患者中，18例为I至II级膀胱输尿管反流，8例为II至IV级。平均解决时间为15.6个月。结论：兄弟姐妹反流发生率显著。然而，与尿路感染后诊断的原发性反流相比，到缓解的分级特定时间似乎缩短了。此外，与“传统”反流相比，肾脏损害的发生率似乎有所降低。虽然推荐筛查是合理的，但我们认为兄弟姐妹反流可能遵循更良性的过程。
Purpose: We determine the efficacy of a prospective screening analysis of an asymptomatic sibling of patients with reflux.Materials and Methods: A total of 78 siblings of patients with reflux were evaluated and 40 (51%) had reflux. The resolution rate and necessity for surgical intervention were evaluated.Results: A total of 40 patients had vesicoureteral reflux, including grade I in 12, II in 33, III in 19 and IV in 1. No patient had gross renal scar on ultrasound or renal pelvis dysmorphism on voiding cystourethrogram. Treatment consisted of prophylactic antibiotics in all. One patient required surgical correction for breakthrough urinary tract infection. Followup was available in 31 patients, of whom reflux resolved completely with medical management in 26. Reflux was downgraded in 4 patients. Of the patients in whom reflux resolved completely grades I to II vesicoureteral reflux were in 18, and II to IV in 8. Mean time to resolution was 15.6 months.Conclusions: The incidence of sibling reflux is significant. However, grade specific time to resolution appears to be decreased compared to primary reflux diagnosed after urinary tract infection. Furthermore, the incidence of renal damage appears to be decreased compared to "traditional" reflux. Although it is reasonable to recommend screening, we suggest that sibling reflux may follow a more benign course.