2010—2018年单中心7 199例儿童肾脏疾病谱特征分析

Kidney diseases spectrum of 7199 children in a single center from 2010 to 2018

目的了解9年间该中心儿童肾脏疾病谱的构成特征及其变化。方法回顾性分析此9年间于肾脏内科住院的7199人次患儿的临床资料,并将患儿分为2010—2012年组、2013—2015年组和2016—2018年组3组,分析比较各组患儿不同年龄阶段比例、重症患儿比例和疾病构成变化特点等。结果研究对象共纳入7199人次。其中,2010—2012年患儿1157人次,2013—2015年患儿2606人次,2016—2018年患儿3436人次。数据比较表明:重症患儿比例显著上升(64.96%vs.36.47%);≤2岁患儿比例从14.26%增至23.14%;肾小球疾病患者比例(81.94%)稳居首位,变化趋势不显著,肾功能异常疾病,如急性肾损伤、慢性肾脏病等,比例呈上升趋势(7.01%vs.3.03%)。这9年间的单病种分析显示:总人数中肾病综合征患儿最多(42.63%),但其构成比呈逐年下降趋势(P<0.001);狼疮性肾炎患儿比例逐渐增高(3.81%vs.1.38%);肾穿刺活检术广泛应用使得确诊IgA肾病的患儿比例呈上升趋势(5.62%vs.1.04%);紫癜性肾炎、急性肾小球肾炎、血尿等疾病变化趋势不明显。结论肾小球疾病仍是最常见的儿童肾脏疾病,重症患儿、肾功能异常患儿构成比均有增长趋势,此类患儿治疗费用高、预后欠佳,因而加强对儿童肾脏疾病的早期筛查、早期干预和早期治疗对提高患儿的生活质量及减轻患者家庭和社会的经济负担具有重要意义。

Objective To investigate the distribution and evolution trend of children′s kidney disease in 9 years by analyzing the data of children in the department of nephrology,Children′s hospital of Zhengzhou from January 2010 to December 2018.Methods The clinical data of 7199 inpatients were retrospectively analyzed.The proportion of children≤2 years old and severe children,the changes of disease composition among 2010-2012,2013-2015 and 2016-2018 were compared.Results All inpatients were divided into three groups,2010-2012 group(1157 inpatients),2013-2015 group(2606 inpatients)and 2016-2018 group(3436 inpatients).Analysis shows a significant increase in the proportion of severe children(64.96%vs.36.47%).The percentage of≤2 years old children increased from 14.26%to 23.14%.Glomerular disease was the most common disease(81.94%).The cases with abnormal renal function were remarkably increased.Nephrotic syndrome was most prevalent disease(42.63%),but showing a downward trend.There was no significant change in the proportion of Henoch Schonlein purpura nephritis oracute glomerulonephritis.More lupus nephritis patients and IgA nephritis were revealed due the application of renal biopsy.Conclusion Glomerular disease is the main children kidney disease.Children with severe diseases or abnormal renal function were recently increased.More attention should be paid to the early screening of children,such as urine routine test.