Table of Contents

HK J Paediatr (New Series)
Vol 19. No. 1, 2014

HK J Paediatr (New Series) 2014;19:15-21

Original Article

Growth of Children with Urolithiasis Associated with Melamine-contaminated Milk Powder: A Follow-up Study
三聚氰胺污染奶粉導致泌尿系統結石的兒童生長發育情況的跟進研究

H Wang, Zy Zhao, L Zhu, Sj Huang, Hh Zhou, Gy Zhou, Jp Wang, Gp Jiang, Xj Chen, Xj Zhou


Abstract

Objective: To study the impact of melamine-contaminated milk powder on children's growth and development and the elimination of urinary tract stones. Patients and Methods: Seventy-three patients aged ≤4 years with ultrasonographically diagnosed urolithiasis after intake of contaminated milk powder were compared with 79 healthy controls. Assessment included indicators of growth and development based on reference data from World Health Organisation (WHO) standards, Brightness mode (B-mode) ultrasonography as well as urine and blood lab analysis. Results: According to WHO standards, whether at time of diagnosis or 18 months after follow-up, urolithiasis patients all showed generally lower z-scores, compared with control. At time of diagnosis, the differences were statistically significant for weight-for-age, weight-for-length and head circumference in children age ≤2 years and for weight-for-age, length/height-for-age and head circumference in the age groups 2 to 3 years and 3 to 4 years (all p<0.05). Eighteen months after follow-up, urolithiasis patient, had significant smaller values for length-for-age in children age ≤2 years and for weight-for-age, length/height-for-age and head circumference in the age groups 2 to 3 years and 3 to 4 years (all p<0.05). While the patient group and the control showed no statistically difference between diagnosis and 18 months follow-up. On follow-up B-mode ultrasonography 18 months after the diagnosis, five (6.85%) children still showed intrarenal calculi, one (1.37%) child suffered from hydronephrosis. Serum levels of alanine aminotransferase, creatinine and uric acid were within normal range. Proteinuria was not observed. Conclusions: Consumption of melamine-contaminated milk power affects growth and development. Melamine-associated urolithiasis can persist for longer periods of time after cessation of melamine intake. A significant long-term effect of contaminated milk powder on liver and kidney function was not observed.

目的:研究三聚氰胺污染奶粉對兒童生長發育影響及泌尿系結石清除情況。病人及方法:以79名健康兒童作為對照組,對比73名年齡少於4歲進食三聚氰胺污染奶粉並由超聲波診斷為泌尿系統結石的兒童。評估方法包括以世界衛生組織標準參考數據評定生長發育指標、B型超聲波、尿液及血液實驗室結果分析。結果:根據世界衛生組織標準,不論是診斷當時或18個月後的跟進,泌尿系統結石患兒均較對照組有較低的z-zone。在診斷時,≤2歲患兒年齡組別的體重、身高及頭圍,2-3歲和4-5歲患兒年齡組別的體重,年齡組別身高體重比對和頭圍均有明顯統計學差異(所有p<0.05)。18個月後的跟進,泌尿系統結石患兒≤2歲的年齡組別的身高,2-3歲和4-5歲患兒年齡組別的體重,身高體重比對和頭圍均明顯小於對照組兒童(所有p<0.05)。病例組和對照組在診斷時和18個月後的跟進無明顯統計學差異。診斷泌尿系統結石18個月後以B型超聲波檢查跟進,5名(6.85%)兒童仍有腎結石,1名(1.37%)兒童患有腎積水。丙氨酸轉氨酶、肌酐及尿素均在正常範圍,無出現蛋白尿。結論:三聚氰胺污染奶粉影響幼兒生長發育。停止食用三聚氰胺污染奶粉一段時間後,三聚氰胺相關泌尿系統結石仍能持續較長時間。在本次研究並未有觀察進食三聚氰胺污染奶粉對兒童造成明顯的遠期肝臟及腎臟功能影響。

Keyword : Children; Growth and development; Melamine; Urolithiasis

關鍵詞:兒童、生長發育、三聚氰胺、泌尿系統結石

 
 

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