婴幼儿期肾病综合征临床特点分析

Analysis of clinical characteristics in infantile nephrotic syndrome

目的 探讨婴幼儿期原发性肾病综合征 (简称婴幼儿肾病 )的临床特点 ;分析婴幼儿肾病临床特点、免疫功能、病理分型和糖皮质激素 (简称激素 )疗效的关系。方法 对 31例婴幼儿肾病患儿进行临床观察 ;进行体液免疫和细胞免疫功能测定 ;14例接受肾穿刺活检 ;31例均采用激素中长程疗法 ,18例予以免疫抑制剂如环磷酰胺 (CTX)等联合治疗。结果 婴幼儿肾病临床以肾炎型肾病为主 ;体液免疫和细胞免疫功能下降 ;病理以非微小病变型为主 ;约 6 0 %患儿对激素治疗不敏感 ,需用激素与免疫抑制剂联合治疗。结论 婴幼儿肾病具有与其它儿童肾病综合征不同的特点 ,应当引起临床重视。

Objective To explore the clinical characteristic of primary nephrotic syndrome in infants (infantile nephrotic syndrome) and relationship among clinical features, immunological function, pathological type and responses to glucocorticoid (hormone).Methods 31 cases with infantile nephrotic syndrome were clinically observed and humoral immunity and cellular immunity were determined. Renal needle biopsy were taken in 14 cases . All patients were treated by middle long term therapy. 18 cases were given combined therapy with immuno suppressive drug (cyclophosphamide).Results The main clinical type of infantile nephrotic syndrome was nephritis nephrotic syndrome. Humoral immunity and cellular immunity function decreased. Pathological types were non minimal change disease in most cases. About 60% cases were not responsive to steroid hormone and combined therapy with immuno suppressive drugs(cyclophosphamide) were needed.Conclusion Infantile nephrotic syndrome has different features from other children's nephrotic syndrome. It should be paid attention in clinical practice.