肺炎支原体感染对原发性肾病综合征患儿激素反应性的影响

The effect of mycoplasma pneumoniae infection on hormone reactivity in children with primary nephrotic syndrome

目的探讨支原体感染对原发性肾病综合征患儿激素反应性的影响。方法所选研究对象为本院收治的初发原发性肾病综合征患儿149例,时间为2014年9月~2017年9月。所有患儿均以被动凝集法检测血清肺炎支原体混合抗体,按照检测结果,将149例患儿分为A组(合并肺炎支原体感染,n=12)、B组(血清支原体混合抗体阴性,n=137)。149例患儿均实施原发性肾病综合征对症治疗。A组确诊后当天或次日给予阿奇霉素5日疗法,分析治疗效果。结果 A组患儿均为单纯型原发性肾病综合征,存在支原体感染相关症状、体征的有7例。治疗后,A组10例患儿症状、体征明显改善,治疗有效;2例因无相关症状、体征,导致无法判断疗效。采用足量糖皮质激素治疗1周内、2周内、3周内、4周内,A组、B组尿蛋白转阴率对比,结果均无统计学意义。结论支原体感染不影响原发性肾病综合征患儿对糖皮质激素的反应性,该结论今后仍需进行大样本、多中心、前瞻性调查,以进一步验证。

Objective To study the effect of mycoplasma infection on the hormone reactivity of primary nephrotic syndrome. Methods The selected subjects were 149 children with primary nephrotic syndrome treated in our hospital, and the time range was September 1, 2014-September 1,2017. All children are passive in mycoplasma pneumoniae antibody mixed serum agglutination method, according to the test results, 149 cases were divided into group A（merger mycoplasma pneumoniae infection, n=12） and group B（mycoplasma mixed serum antibody negative, n=137）. All 149 children were treated with primary nephrotic syndrome.Azithromycin was treated the same day or the next day after the diagnosis of group A. Analyze the therapeutic effect. Results All the children in group A were simple primary nephrotic syndrome, and there were 7 cases of mycoplasma infection related symptoms and signs; After treatment, the symptoms and signs of 10 children in group A were significantly improved, and the treatment was effective; Two patients were unable to determine the efficacy due to the absence of related symptoms and signs; The results showed no statistical significance（P〈0.05） in the comparison of urinary protein conversion rate in group A and group B within 1 week, 2 weeks, 3 weeks and 4 weeks after treatment with adequate glucocorticoid. Conclusion Mycoplasma infection does not affect the response of children with primary nephrotic syndrome to glucocorticoid, and it is still necessary to conduct a large sample, multi-center and prospective investigation for further verification.