儿童原发性肾病综合征40例临床分析

Clinical analysis of 40 children with primary nephrotic syndrome

目的:探讨儿童原发性肾病综合征的临床特征。方法:对40例原发性肾病综合征患儿的临床资料进行回顾性分析,其中单纯性肾病31例,肾炎性肾病9例。结果:患儿临床表现以水肿为主,且为就诊首要原因。经休息、限制钠的摄入、利尿消肿,以及应用肾上腺皮质激素和细胞毒药物治疗,单纯性肾病完全缓解率70.1%,肾炎性肾病完全缓解率33.3%。合并感染9例均为呼吸道感染,低钠血症4例,甲状腺功能减低2例,急性肾功能不全2例,脑血管栓塞1例。结论:儿童原发性肾病综合征经泼尼松治疗单纯型肾病完全缓解率高于肾炎性肾病,对激素耐药的肾病综合征患儿采用免疫抑制剂有一定的疗效,治疗过程中应注意并发症及加强对患者及家属治疗依从性教育。

Objective：To investigate the clinical characteristics of children with primary nephrotic syndrome. Methods：The clinical data of 40 children with primary nephrotic syndrome （ including 31 cases of simple nephrotic syndrome and 9 cases of nephritis nephropathy） were retrospectively analyzed. Results：Edema was the major clinical manifestation of children, and the primary reason for seeing doctor. All children were treated with rest, limiting sodium intaking and adrenal cortical hormone and cytotoxic drugs. The complete remission rates of simple nephrotic syndrome and nephritis nephropathy were 70. 1% and 33.3%, respectively. Respiratory tract infection in 9 cases, hyponatremia in 4 cases, hypothyroidism in 2 cases, acute renal insufficiency in 2 cases and cerebral embolism in 1 case were found. Conclusions： The complete remission rate of simple nephrotic syndrome treated with prednisone is higher than that in nephritis nephropathy treated with prednisone. Immune inhibitor in the treatment of steroid-resistant children with primary nephrotic syndrome has certain effect. The complications of patients and compliance education of patients and their famihes should be strengthened during treatment.