儿童频复发与非频复发型原发单纯型肾病综合征感染特点比较

A Comparative Study on Infection Characteristics of Child Primary Simple Nephrotic Syndromes at Frequent Relapses and Non-frequent Relapses

目的比较儿童频复发和非频复发型原发单纯型肾病综合征合并感染的临床特点。方法对我科2014年7月—2016年7月收治的184例频复发肾病综合征和51例非频复发肾病综合征患儿感染发生率、感染部位、病原分布、部分炎症指标进行回顾性分析,并应用SPSS 19.0软件对结果进行统计学分析。结果 (1)感染发生率:频复发组合并消化道感染发生率高于非频复发组(P<0.05);两组其他系统感染发生率无差异;两组各年龄段感染发生率无差异。(2)感染部位:频复发组合并2个部位感染发生率高于非频复发组(P<0.05);两组均以呼吸道感染最常见,但无统计学意义。(3)病原分布:肺炎支原体抗体、EB病毒DNA(EB-DNA)、巨细胞病毒DNA(CMV-DNA)、流感病毒A、副流感病毒、抗链球菌溶血素"O"(ASO)、乙肝病毒DNA、轮状病毒、巨细胞病毒IgM、风疹病毒IgM等病原学检查阳性率无差异。(4)部分炎症指标:两组血常规、C反应蛋白(CRP)、降钙素原(PCT)阳性率无差异。结论频复发肾病综合征较非频复发肾病综合征可能更易合并消化道感染,出现2个部位感染几率高。因此对肾病综合征患儿,特别是频复发的患儿应积极预防和控制感染,尤其是消化道感染;同时应注意多部位感染,以改善病情及预后。

Objective The article compares the clinical features of concurrent infection between frequent relapses and non - frequent relapses of child primary simple nephrotic syndromes. Methods The paper focused on the retrospective analysis on the incidence rate of infection, infection site, distribution of pathogen, and certain Inflammatory biomarkers of children with primary simple nephrotic syndromes between 184 cases of frequent relapses and 51 cases of non - frequent relap-ses from July, 2014 to July, 2017, all hospitalized in the Department of Pediatrics of the Second Affiliated Hospital of Guang-zhou University of Traditional Chinese Medicine. Statistical analysis with SPSS 19. 0 was done on the retrospective results. Results 1. The incidence of infection of the frequent relapses group was higher than that of non - frequent relapses group （P 〈 0. 05 ） . There were no differences between other two systems and so it was with the age groups. 2. The merged two sites of incidence of infection within the frequent relapse group was higher than that of the non - frequent relapses group （P 〈 0. 05 ）. The infections in the respiratory tracts were found in both two groups without statistical significance. 3. The etiologi-cal examination of positive rates showed no differences in view of mycoplasma hyopneumoniae antibody, EB - DNA, CMV - DNA, influenza vims A, parainfluenza, ASO, hepatitis B DNA, rotavirus, CMV （IgM） and rubella vims （ IgM） , etc. 4. Concerning inflammatory biomarkers, no differences of the positive rates were found between the two groups by blood routine examination, C reactive protein （CRP） and procalcitonin （PCT） . Conclusion The nephrotic syndromes with frequent re-lapses are more inclined to merge in the respiratory tract than non - frequent relapses. The infections are more likely to appear in two sites. For these children who have nephrotic syndromes, especially those with frequent relapses and respiratory tract in-fections, we should prevent and control infection actively. At the same time, attention should be paid to multiple site infec-tions in order to improve pathogenic condition and prognosis.