北大三聚氰胺研究成果登IF52权威期刊

　　

生物通报道，北京大学附属第一医院，附属第三医院，临床流行病研究中心在国际权威期刊New England Journal of Medicine发表关于三聚氰胺患儿的最新临床调查研究报告。

 

文章的通讯作者为北京大学第一医院副院长，中华医学会小儿内科分会肾病专业组组长丁洁教授。在三聚氰胺事件过程中，丁洁教授曾参与一线的工作，在卫生部的新闻发布会上呼吁患儿早诊断，早治疗，避免患儿因结石而死亡。

 

研究人员对结石患儿（年龄约36月大或更小）临床病医学调查，通过验尿，肾功能检测，肝功能检测，尿液生化检测，和超声波检测多种手段临床监测患儿的病情。整个研究调查了589名病例，其中有421个有摄入三聚氰胺史。

 

结果发现，有50名小孩患有尿结石，其中包括8名没有三聚氰胺摄入史的小孩，112名患者疑似尿结石症状，427名没有结石。在有尿结石的患儿中，5.9%有血尿症，2.9%有白细胞尿症状，而其他没有结石和疑似有结石的小孩间的症状没有明显的区别。22名有结石的患儿其血清肌酸酐，尿素氮，和丙氨酸氨基转移酶都维持在正常水平。41名结石患儿中有4名（9.8%）其肾小球功能异常，41名患儿都没有出现肾小管功能障碍。

 

调查结果统计发现，摄入高浓度的三聚氰胺的患儿罹患结石的几率比无三聚氰胺摄入史的儿童高7倍。早产儿比足月儿患结石的几率高4.5倍。

 

调查结果最终显示，早产儿和暴露在三聚氰胺下的婴儿比较容易患肾结石。有肾结石的患儿常表现出缺乏临床症状的现象。

 

这些研究成果无疑给临床工作者提供了初步的指导。（生物通 小茜）

生物通推荐原文检索：Melamine-Contaminated Powdered Formula and Urolithiasis in Young Children

 

【Abstract】

 

Background A recent epidemic of melamine contamination of baby formula in China has been associated with the development of urinary tract stones, though the clinical manifestations and predisposing factors are incompletely delineated.

 

Methods We administered a questionnaire to the parents of children 36 months of age or younger who were being screened for a history of exposure to melamine and symptoms of, and possible predisposing factors for, urinary tract stones. In addition, we performed urinalysis, renal-function and liver-function tests, urinary tests for biochemical markers and the calcium:creatinine ratio, and ultrasonography. Powdered-milk infant formulas were classified as having a high melamine content (>500 ppm), a moderate melamine content (<150 ppm), or no melamine (0 ppm); no formulas contained between 150 and 500 ppm of melamine.

 

Results Contaminated formula was ingested by 421 of 589 children. Fifty had urinary stones, including 8 who had not received melamine-contaminated formula; 112 were suspected to have stones; and 427 had no stones. Among children with stones, 5.9% had hematuria and 2.9% had leukocyturia, percentages that did not differ significantly from those among children who were suspected to have stones or those who did not have stones. Serum creatinine, urea nitrogen, and alanine aminotransferase levels were normal in the 22 children with stones who were tested. Four of the 41 children (9.8%) who had stones and in whom urinary markers of glomerular function were measured had evidence of abnormalities; none had tubular dysfunction. Children exposed to high-melamine formula were 7.0 times as likely to have stones as those exposed to no-melamine formula. Preterm infants were 4.5 times as likely to have stones as term infants.

 

Conclusions Prematurity and exposure to melamine-contaminated formula were associated with urinary stones. Affected children lacked typical signs and symptoms of urolithiasis. （生物通）

 

丁洁

1982年毕业于北京医学院医疗系，1989年获医学博士学位，1994年在美国完成博士后及多年学习工作后回国。现为北京大学第一医院副院长，儿科副主任、儿科教授、研究员、博士生导师。现任国际儿科学会常委，亚洲小儿肾脏病学会理事，中华医学会儿科学分会肾脏学组组长，任北京大学学报（医学版）以及PEDIATRICS中文版副主编，任中华儿科杂志、中华肾脏病杂志等10余家国内学术期刊编委，任国际学术期刊儿科肾脏病杂志（Pediatric Nephrology）、美国肾脏病杂志（American Journal of Kidney Diseases）以及国际肾脏病杂志（Kidney International）审稿专家。多年来一直从事小儿肾脏疾病的研究、临床以及教学工作，注重紧密结合临床实践进行系列研究工作，在儿童遗传性肾脏疾病临床诊治和遗传学方面的工作、以及从足细胞角度探讨蛋白尿发生机制方面的工作处于国内领先国际先进，相关工作作为课题负责人先后获得十余项国家级、部委级及北京市级科研基金的资助，研究结果作为第一作者或责任作者在国际国内发表论文150余篇。作为第一完成人曾获国家科学技术进步奖（二等）、中华医学科技奖（一等）、北京市科技进步奖（二等）。培养博（硕）士研究生20余位。