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本文选择27例发作性肉眼血尿作24小时尿钙排泄量及尿钙/尿肌酐比值测定,其中11例24小时尿钙量(5.5±0.9mg/kg)和Ca/Cr(0.39±0.17)均大于正常值,诊断为IH。该11例空腹试验结果:7例尿Ca/Cr为0.26±0.04,符合肾型IH;4例尿Ca/Cr为0.13±0.03,符合吸收型IH。负荷试验结果:7例肾型IH尿Ca/Cr 0.49±0.05,尿钙6.4±0.34mg/kg/日;4例吸收型IH尿Ca/Cr 0.27±0.04,尿钙4.8±0.42mg/kg/日。IH血尿是X线不能检出的微小结石或结晶损伤肾小管上皮所致。因反覆血尿,3例肾型IH给服双氢克尿塞,1例吸收型仅鼓励多饮水,均获得满意疗效。IH是小儿血尿的主要原因,凡遇不明原因的血尿应常规作尿钙排泄试验、尿Ca/Cr测定,以明确诊断。
In this study, 27 patients with episodic gross hematuria were selected for 24-hour urinary calcium excretion and urinary calcium / urinary creatinine ratio. Eleven 24-hour urinary calcium (5.5 ± 0.9 mg / kg) and Ca / Cr (0.39 ± 0.17) Greater than normal, diagnosed as IH. The fasting test results of 11 cases: 7 cases of urinary Ca / Cr was 0.26 ± 0.04, in line with renal IH; 4 cases of urinary Ca / Cr was 0.13 ± 0.03, in line with absorption IH. The results of the load test showed that the urinary calcium was 0.49 ± 0.05 and the urine calcium was 6.4 ± 0.34mg / kg / day in 7 cases of renal IH, Ca / Cr 0.27 ± 0.04, 4.8 ± 0.42mg / kg / day. IH hematuria is a small stone or crystalline X-ray can not be detected due to renal tubular epithelial injury. Due to hematuria, 3 cases of renal type IH to take hydrochlorothiazide, 1 case of absorption-type only to encourage more water, were satisfactory results. IH is the main reason for hematuria in children, where the case of unexplained hematuria should be routine urine calcium excretion tests, urinary Ca / Cr determination to confirm the diagnosis.