The Most Common Hematuria in Children: Clinical Evaluation and Differential Diagnosis

兒童血尿之發生率約1.5%。而以每視野鏡檢下，可見到有5個以上之紅血球時，則為定義血尿之最常取用的方法。當一位兒童之尿液試紙呈陽性血尿反應時，而其尿液顯微鏡檢中也同時存在者一些紅血球時，這對一個被稱之為“血尿病童”之確定診斷是很重要的。對一位血尿病童而言，需作鑑別診斷之疾病雖不少，但仍以有或無蛋白尿之存在代表腎疾病預後之重要指標。當一位血尿病童同時存在有明顯之蛋白尿時，則需一快捷之評估並及早轉介給小兒腎臟醫師診治。反之，當血尿病童並無蛋白尿之同時存在時，則可依血尿檢測之相關步驟來進行評估，並做追蹤檢查。雖然大部分無臨床症狀之顯微血尿病童，在其腎絲球病理檢查中，往往並沒有明顯之異常發現，但這些病童一旦出現有明顯之蛋白尿，高血壓、甚至於切片檢查之異常，則須腎臟專科醫師之長期追蹤評估。

關鍵字

血尿；變形紅血球；原形紅血球

並列摘要

Hematuria occurs in approximately 1.5% of children. It is important in evaluating the patient who has hematuria to make sure that a positive dipstick test accompanied by RBCs on the microscopic examination. Hematuria is defined by several parameters, the most common is 5 cells per high-power field in a urinary sediment. Although the differential diagnosis for hematuria is extensive, the most important differentiating feature is the presence or absence of proteinuria. Those who have significant proteinuria deserve a rapid evaluation and early referral to a nephrologist. Those who do not have proteinuria should be followed and a stepwise evaluation performed. Most patients who have asymptomatic microscopic hematuria do not have clinically significant glomerular pathology, but in those patients who had poor prognostic indicators including significant proteinuria, hypertension or changes on biopsy, long-term evaluation by a nephrologist is needed.

並列關鍵字

hematuria ； dysmorphic RBC ； eumorphic RBC

國際替代計量

The Most Common Hematuria in Children: Clinical Evaluation and Differential Diagnosis

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