656例原发性肾小球疾病患儿心血管损害临床分析

Clinical analysis of primary glomerular disease with cardiovascular damage among 656 pediatric patients

目的探讨原发性肾小球疾病住院患儿合并心血管系统损害的临床特点,为及早防治提供临床依据。方法回顾性分析2005年1月至2010年12月656例原发性肾小球疾病住院患儿病理类型及合并心血管损害的临床表现。结果 656例原发性肾小球疾病患儿中303例合并心血管系统损害。急进性肾炎8例合并心血管损害8例(合并率100%),肾炎性肾病110例合并心血管损害70例(合并率63.64%),急性肾炎124例合并心血管损害76例(合并率61.29%)。原发性肾小球疾病合并心血管损害的各种临床表现中,发生率依次为心率增快(35.82%),心电图ST-T改变(35.03%),血压升高(26.52%)等。656例原发性肾小球疾病中表现为少尿或无尿者212例,其中154例合并心血管损害(72.64%);249例有氮质血症,其中176例合并心血管损害(70.68%);有水肿表现者393例,其中261例合并心血管损害(66.41%)。结论原发性肾小球疾病中急进性肾炎、肾炎性肾病、急性肾炎类型合并心血管系统损害的发生率较高;原发性肾小球疾病合并心血管损害的主要临床表现为心率增快、心电图ST-T改变、血压升高、心脏杂音等;水肿、氮质血症、少尿或无尿是原发性肾小球疾病合并心血管损害的危险因素。

Objective To investigate the clinical features of the primary glomerular disease with damage to the cardiovascular system for prevention and treatment of primary glomerular disease with early cardiovascular damage provide clinical basis. Methods The retrospective analysis of our department in January 2005 - December 2010 656 cases of hospitalized children with primary glomerular disease by gender, age, pathological type and clinical manifestations of cardiovascular damage. Results 656 patients with primary glomerular diseases in children, 303 cases with cardiovascular system damage. Rapidly progressive glomerulonephritis 8 cases with cardiovascular damage in 8 cases （combined rate of 100% ） , nephritis nephrotic 110 cases with cardiovascular damage 70 （combined rate of 63.64% ） , acute nephritis 124 eases ,of witch 76 patients with cardiovascular damage. （combined rate of 61.29% ）. The various clinical manifestations of primary glomer- ular diseases with cardiovascular damage include increased heart rate （ 35.82% ） , ECG ST - T changes （35.03%） , elevated blood pressure （26.52%） , etc. 656 cases of primary glomerular diseases showed liltle m＇ no urine 212 cases, of which 154 cases with cardiovascular damage （72.64%） ;249 cases with azotemia, of which 176 cases with cardiovascular damage （70.68 % ） ; edema patients accounted of 393 cases, of which 261 cases with cardiovascular damage （66.41%）. Conclusion The incidence of the rapidly progressive glomerulonephritis, nephritis, kidney disease, acute nephritis combined cardiovascular damage higher in the primary glomemlar diseases; the main clinical manifestations of primary glomerular diseases with cardiovascular damage include Increased heart rate, elevated blood pressure, cardiac enlargement, ECG ST - T changes, heart failure, etc. ; edema, azotemia, oliguria or anuria are the risk factors of a primary glomerular disease with cardiovascular damage.