儿童原发性肾病综合征并发急性胰腺炎14例临床分析

Clinical analysis of primary nephrotic syndrome complicated with acute pancreatitis in 14 children

目的探讨儿童原发性肾病综合征并发急性胰腺炎的诊断及治疗。方法回顾分析2013年9月至2016年9月收治的14例原发性肾病综合征并发急性胰腺炎患儿的临床资料。结果 14例患儿中,男6例、女8例,年龄3~15岁。14例患儿临床表现为大量蛋白尿、低白蛋白血症、不同程度的水肿及高脂血症,均于病程中出现上腹部或左季肋部腹痛,7例患儿出现恶心、呕吐;血淀粉酶392~802 U/L,脂肪酶(339.1±2.52)U/L,尿淀粉酶561~3 180 U/L。除1例放弃治疗外,13例患儿经支持治疗后,胰腺炎痊愈。结论原发性肾病综合征患儿因存在感染、凝血功能紊乱、高血脂及药物应用等因素,可能诱发急性胰腺炎发生,临床须警惕,并尽早诊断和治疗。

ObjectiveTo explore and provide guidelines for the clinical diagnosis and treatment of primary nephrotic syndrome complicated with acute pancreatitis. MethodsThe clinical data of 14 children with primary nephrotic syndrome complicated with acute pancreatitis during September 2013 to September 2016 were retrospectively analyzed. ResultsIn 14 children （6 males and 8 females） aged 3 to 15 years. all children presented massive proteinuria, hypoalbuminemia, varying degrees of edema, hyperlipidemia and pain in upper abdomen or left hypochondrium. Seven children had nausea and vomiting, and their amylase in serum and urine fuctuated at 392？802 U/L and 561？3180 U/L, and the lipase level was 339.1±2.52 U/L. After supportive treatment, 13 children were cured from pancreatitis except one who gave up the treatment. ConclusionDue to infection, coagulation disorder, hyperlipidemia and drug application in primary nephrotic syndrome, acute pancreatitis may be induced. Clinician should be alerted to it and early diagnosis and treatment were needed for acute pancreatitis.