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目的探讨食用含三聚氰胺奶粉致婴幼儿泌尿系统结石的危险因素。方法2008年本院在对食用含三聚氰胺奶粉婴幼儿进行泌尿系统结石筛查的基础上,对242例泌尿系统结石患儿[病例组。男149例,女93例;年龄(19.092±9.903)个月;食用三聚氰胺污染奶粉时间(14.960±9.055)个月]和242例无尿路结石的婴幼儿[对照组。男149例,女93例;年龄(18.682±9.558)个月;食用三聚氰胺污染奶粉时间(15.240±9.356)个月]进行病例对照研究,以年龄、性别、城乡区域、喂养方式相同作为配比条件。从既往研究和已有文献中选取7项可能影响泌尿系统结石形成的相关危险因素,采用SPSS12.0软件对数据进行χ2检验、单因素及多因素条件Logistic回归分析。结果食用含三聚氰胺高的三鹿奶粉患儿165例,其中结石患儿151例,占总数的62.40%;食用非三鹿奶粉319例,泌尿系结石91例,占37.60%。单因素分析显示,在选取的7种危险因素中,仅食用不同品牌含三聚氰胺奶粉、平均每日饮水量在病例组与对照组间比较差异有统计学意义(Pa<0.01),但饮用水来源、出汗量、补充钙剂、奶粉冲服方式和奶粉食用时间比较差异无统计学意义(Pa>0.05)。多因素分析证实食用含三聚氰胺高的奶粉和饮水量不足与婴幼儿泌尿系统结石显著相关,其OR值(95%可信区间)分别为26.878(14.729～49.049)和2.077(1.108～3.891)。结论食用三聚氰胺含量较高的奶粉和饮水量不足是婴幼儿泌尿系统结石形成的主要危险因素,预防婴幼儿泌尿系统结石最有效、最安全和最廉价的方法为多饮水。
Objective To investigate the risk factors of urinary tract calculi induced by melamine milk powder in infants and young children. Methods In 2008, our hospital conducted a series of urinary calculi tests on 242 children with urinary system stones on the basis of screening urinary stones in infants with melamine milk powder [case group. 149 males and 93 females, aged 19.092 ± 9.903 months, melamine-contaminated milk powder time (14.960 ± 9.055) months, and 242 infants without urolithiasis [control group. 149 cases were male and 93 cases were female. The age (18.682 ± 9.558) months and the melamine-contaminated milk powder time (15.240 ± 9.356) months were compared. Case-control study was conducted on the basis of age, sex, urban and rural areas, . Seven risk factors that may affect the formation of urolithiasis were selected from the previous studies and the existing literatures. The data were analyzed by χ2 test using SPSS12.0 software, single factor and multivariate Logistic regression analysis. Results The children with high melamine Sanlu milk powder contained 165 cases, of which 151 cases of stone children, accounting for 62.40% of the total; 319 cases of non-Sanlu milk powder, 91 cases of urinary stones, accounting for 37.60%. Univariate analysis showed that among the seven risk factors selected, only the consumption of different brands of melamine milk powder, the average daily drinking water in the case group and the control group, the difference was statistically significant (Pa <0.01), but drinking water source There was no significant difference in the amount of sweating, calcium supplementation, milk formula and milk formula consumption (Pa> 0.05). Multivariate analysis confirmed that consumption of melamine-rich milk powder and inadequate drinking water were significantly associated with urinary stones in infants and young children. The OR (95% confidence interval) were 26.878 (14.729 to 49.049) and 2.077 (1.108 to 3.891), respectively. Conclusions The inadequate intake of milk powder and drinking water with high content of melamine is the main risk factor for the formation of urinary stones in infants and young children. The most effective, safest and cheapest way to prevent urinary stones in infants and young children is to drink more water.