重症急性链球菌感染后肾炎患儿血压变化规律及相关因素分析

Severe Acute Nephritis after Streptococcal Infection in children with Blood Pressure Changes and Related Factors

目的:观察急性链球菌感染后肾炎(APSGN)患儿血压变化规律。方法:观察15例重型APSGN(重型组)和20例普通型APSGN(普通组)患儿病程中各时期血压及尿量变化,并进行免疫和生化指标对比。结果:APSGN患儿高血压总共26例(74.29%),其中重症组高血压14例(93.3%),普通组高血压12例(60%),高血压发生率重症组高于普通组P<0.05。重症APSGN患儿入院时舒张压、少尿期收缩压舒张压、多尿期舒张压与普通组比较均有显著性差异,P<0.05;而且重症APSGN与普通组在少尿期持续时间、尿量、多尿期持续时间、尿量的指标比较也均有显著性差异,P<0.05。重症APSGN患儿血IgG、BUN、Cr明显高于普通APSGN,P<0.05。结论:高血压是APSGN主要临床表现之一,血压增高多发生于少尿期,但重症APSGN患儿于多尿期出现血压增高的第二次高峰,临床上应注意监测,及时治疗。

Objective：To observe the law of the changes of children＇s blood pressure after the infection of steptococcus with acute nephritis（APSGN）.Methods：Watching 15 cases of serious APSGN and 20 cases of ordinary APSGN for their changes in blood pressure and their urine amounts in various periods;contrasting their indexes in immunity and biochemistry.Results：Among 26cases（74.29%）of patients＇high blood pressure with APSGN,of which 14cases （93.3%）are serious ones and 12cases （60%）are ordinary ones,the occurrence rate of the serious group is higher than that of the ordinary group,P〈0.05.At the initial stage,either the diastolic presssure or the diastolic pressure and the systolic pressure of the serious group with a small amount of unine,the diastolic pressure with a large amount of urine are evidently different from those of the ordinary group,P〈0.05.Furthermore,there are evident differences in the durations and amounts of urine with either a small or a large amount of urine,P〈0.05.The IgG,BUN and Cr of the serious group are evidently higher than those of the ordinary group,P〈0.05.Conclusion：High blood pressure is one of the main clinical manifestations of APSGN.The increase of blood pressure mostly occurs during the period of a small amount of urine,but a second summit of high blood pressure with APSGN mostly appears in the period of a large amount of urine.It must be closely observed and therefore given the timely treatment.