肾病综合征激素敏感频复发患儿与支原体感染

Association of mycoplasma infection with frequent relapses of steroid-sensitive nephrotic syndrome in children

目的:探讨原发性肾病综合征(NS)激素敏感频复发患儿与肺炎支原体感染的关系。方法:选取原发性肾病综合征激素敏感频复发患儿同时合并急性呼吸道感染者共35例,根据结果分肺炎支原体(MP)感染患儿为观察组,其他感染患儿为对照组,观察患儿的临床特征,对比治疗前后的各项检验指标的变化,包括24小时尿蛋白定量(24 h-Upro)、尿素氮(BUN)、血肌酐(Scr)、血浆白蛋白(Alb)、总胆固醇(Chol)等。统计分析两组患儿的治疗疗效。结果:两组治疗后各项临床生化指标均有明显改善,差异有统计学意义(P≤0.01)。治疗后24 h尿蛋白定量下降明显,从数值上看观察组较对照组下降更明显。观察组18例患儿治疗有效15例,其中完全缓解9例,部分缓解6例;对照组17例患儿治疗有效14例,其中完全缓解6例,部分缓解8例。结论:急性呼吸道感染诱发的激素敏感频复发NS患儿经过治疗后,多数能得到缓解,蛋白尿、低蛋白血症、高脂血脂、肾功能均恢复较快,预后好,其中应用阿奇霉素治疗MP感染诱发的激素敏感频复发的NS患儿疗效更显著。

Objective To explore the correlation of mycoplasma pneumoniae infection with frequent relapses of steroid-sensitive nephrotic syndrome （SSNS） in children. Methods 35 patients with relapse of SSNS and acute respiratory tract infection were divided into a observation group （myc0plasma pneumoniae infection） and a control group. The clinical and laboratory data including 24 h urine protein （24 h-Upro）, urea nitrogen （Bun）, serum ereatinine （Scr）, albumin （Alb） and cholesterol （Chol） were analyzed before and after treatment. Results The clinical and laboratory indexes were obviously improved after treatment, the difference was statistically significant （P ≤ 0.01）. 24 h-Upro decreased more significantly in the observation group than in the control group after treatment. In the observation group, 15 of 18 children achieved the efficacy, 9 of whom had complete response and 6 had partial response. In the control group, 14 patients achieved the efficacy, 6 of whom had complete response and 8 had partial response. Conclusions After treatment, most of the children with frequent relapses of steroid-sensitive nephrotic syndrome induced by cute respiratory infection are relieved. Proteinuria, hypoproteinemia, hyperlipidemia, and renal function were improved in those patients. Therapies with azithromycin achieves a more marked efficacy.