中国循证儿科杂志2011，Vol.6Issue(2)：115-119,5.DOI:10.3969/j.issn.1673-5501.2011.02.008
原发性肾病综合征患儿539例病理类型及随访
Pathological and follow-up studies in 539 children with primary nephrotic syndrome
李志辉 1银燕 1段翠蓉 1寻劢 1张翼 1吴天慧 1丁云峰 1张丽琼1
作者信息
- 1. 湖南省儿童医院肾内科,湖南省儿科医学研究所肾脏病研究室,长沙,410007
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摘要
Abstract
Objective To study the feature of treatment, pathology and follow-up in children with primary nephrotic syndrome ( PNS ).Methods Children with PNS hospitalized in Department of Nephrology of Hunan Children 's Hospital from January 2005 to December 2009 who had heen followed-up longer than 6 months were included.PNS patients were grouped into ＜2 years, - 5 years , - 10 years and ＞ 10 years groups according to age.The information of treatment, renal pathological lesion and follow-up data in children with PNS were analyzed.Results Five hundred and thirty-nine children ( including 402 boys and 137 girls ) with PNS were investigated in the study.The ratio of boys to girls was 2.9.Among them.159 ( 29.5％ ) were under 2 years of age, 269 ( 49.9％ ) aged 2 -5 years, 84( 15.6％ ) aged 5 - 10 years, and 27( 5.O％ ) aged over 10 years.①Among them 274 ( 50.8％ ) patients showed minimal change disease , 79 ( 14.7％ ) patients showed focal segment glomerulosclerosis, 173( 32.1％ )patients showed mesangioproliferative glomerulonephritis, 6( 1.1％ ) patients showed membranoproliferative glomerulonephritis.and 7( 1.3％ ) patients showed others-s pathologic lesion.The proportional distribution of pathologic lesion type in kidney among 4 groups ( ＜2 years, -5 years, - 10 years and ＞ 10 years ) was signifiantly different ( P ＜0.05 ).②The major pathology pattern of children with steroid sensitive and resistant PNS was mmimal change disease ( 62.4％ and 69.6％ , respectively ).The major pathology pattern of children with steroid dependant PNS was mesangioproliferative glomerulonephritis( 48.4％ ).③239/539 patients were with complete remission.75 with partial remission, 61 invalid.158 with symptomatic control, urine protein ( - ),but still taking prednisone.Six cases died due to glucocorticoid resistance with severe infection or progression to end - stage renal disease to give up medical treatment.Conclusions In recent years, the age of onset.sex, pathologic lesion type and response to steroid therapy of children with PNS may change, and there existed significant differences in patients with different ages.关键词
儿童/原发性肾病综合征/病理/糖皮质激素/随访引用本文复制引用
李志辉,银燕,段翠蓉,寻劢,张翼,吴天慧,丁云峰,张丽琼..原发性肾病综合征患儿539例病理类型及随访[J].中国循证儿科杂志,2011,6(2):115-119,5.
