中国循证儿科杂志2017，Vol.12Issue(2)：131-134,4.DOI:10.3969/j.issn.1673-5501.2017.02.010
基于病例对照研究的儿童肾病综合征低白蛋白血症诊断标准探讨
Retrospective case control study on the creteria of hypoalbuminemia in the diagnosis of nephrotic syndrome in children
管娜 1丁洁 1杨霁云 1肖慧捷 1姚勇 1刘景城 1钟旭辉 1王芳 1朱赛楠1
作者信息
- 1. 北京大学第一医院儿科 北京,100034
- 折叠
摘要
Abstract
Objective To investigate the diagnostic criteria of hypoalbuminemia in nephrotic syndrome in children.Methods Data from children with idiopathic nephrotic syndrome hospitalized in Peking University First Hospital during January of 1993 to December of 2012 were collected and analyzed retrospectively.Children were divided into 2 groups,including a group with serum albumin 25 to 30 g·L-1and another group with serum albumin < 25 g·L-1at onset.Data on children's general information,renal pathology,clinical presentations,treatment,steroid response,serious complications and prognosis were compared between two groups.Results Data from 458 children were analyzed including 28 cases in group with serum albumin 25 to 30 g·L-1and 430 cases in group with serum albumin less than 25 g·L-1.No significant differences were found in gender and onset age between two groups.①Twelve children from group with serum albumin < 25 g·L-1and 141 children from group with serum albumin 25 to 30 g·L-1underwent renal biopsy.There was no significant difference in the renal pathological diagnosis type between two groups.Focal segmental glomerulosclerosis was the most common pathological change in both groups.Minimal change disease or minor change disease accounted for 21.9%in group with serum albumin < 25 g·L-1and 8.3％in group with serum albumin 25 to 30 g·L-1.② There were no significant differences between two groups in the clinical phenotype,the kinds of immunosuppressant,the occurrence of severe complications and the incidence of steroid related adverse events.There was a significant difference in steroid response between the two groups.The steroid response rate was 68.4％(294/430)in group with serum albumin < 25 g·L-1and 50.0％(14/28)in group with serum albumin 25 to 30 g·L-1.③The occurrence of serious prognosis in group with serum albumin 25 to 30 g·L-1was significantly higher than in group with serum albumin < 25 g·L-1(14.3％vs 4.4％,P=0.04).Conclusion Children with heavy proteinuria and serum albumin 25 to 30 g·L-1manifested mainly with non minimal/minor change disease and more serious prognosis.Early renal biopsy should be performed on them.关键词
儿童/肾病综合征/低白蛋白血症/病理/预后Key words
Children/Nephrotic syndrome/Hypoalbuminemia/Pathology/Prognosis引用本文复制引用
管娜,丁洁,杨霁云,肖慧捷,姚勇,刘景城,钟旭辉,王芳,朱赛楠..基于病例对照研究的儿童肾病综合征低白蛋白血症诊断标准探讨[J].中国循证儿科杂志,2017,12(2):131-134,4.
