儿童慢性肾功能衰竭病因及临床特点

The etiology along with its clinic character of children chronic renal failure

目的 分析慢性肾功能衰竭(chronic renal failure,CRF)患儿的病因及临床特点,提高对 CRF的认识。方法 分析整理59例慢性肾衰病儿的病史资料、体格检查、辅助检查及病理报告,并比较不同贫血程度病儿的血肌酐(Scr)的差异。结果 59例CRF中慢性肾炎49例(83.05%),泌尿系统先天性畸形10例(16.90%),全部病例都有不同程度的贫血,贫血越重,Scr水平越高,其差异具有显著性(P<0.01)。前者出现多饮多尿更明显,后者骨骼畸形和生长发育落后更多。10例肾活检结果为局灶节段性肾小球硬化4例、硬化性肾小球肾炎3例、膜增殖性肾小球肾炎2例、IgA肾炎 1 例, 其 Scr低于平均水平(P<0.05)。结论 CRF的主要原发病因是慢性肾炎,应加强对慢性肾炎、泌尿系统先天性畸形的随访,以达到 CRF早诊断、早治疗的目的;早期肾活检能指导治疗,有望改善CRF的预后。

Objective To analyze the etiology along with its clinic character of children chronic renal failure(CRF) and to enhance the realization for the essence of the chronic renal failure.Methods To analyze and process the data of the history,physical examination, laboratory test and the kidney pathologic report in 59 pediatric cases of chronic renal failure.Comparison of the level of serum Cr in the patients with different degree of anemia was pienforwed.Results There are 49 cases of chronic nephritis( 83.05 %),10 cases of congenital abnormality (6.90%),the diagnosis of anemia in different degree exists in all the cases.The severer the symptom of anemia is,the higher the lever of serum Cr is,and the difference is notable.The frequency of uresis in the former patients is higher while bone malformation and growth stasis are more observed in the latter ones.In 10 kidney pathogen reports:there are 4 cases of focal segmental glomerulosclerosis,3 cases of sclerosis nephritis,2 cases of membranoproliferative glomerulonephritis,1 case of IgA nephritis, and its level of serum Cr is lower than the average.Conclusion Chronic nephritis is the primary reason for CRF.We should emphasize the importance on following-up to the patient of congenital abnormality and chronic nephritis which help for diagnosis;renal pathological exam in early stage can instruct the treatment and amelioration the prognosis of CRF.