急性肾损伤121例临床与病理分析  

Clinical and Pathologic Analysis of 121 Children with Acute Kidney Injury

作　　者：杜悦[1] 张慧[1] 侯玲[1] 韩梅[1] 吴玉斌[1] 

机构地区：[1]中国医科大学附属盛京医院儿肾科,沈阳110004

出　　处：《实用儿科临床杂志》2011年第18期1410-1412,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨儿童急性肾损伤(AKI)发病情况、病因、病理改变及病程转归情况。方法回顾性分析2005年9月-2010年9月本院儿肾科收治的所有AKI患儿发病情况、临床诊断、病理诊断、住院天数及预后资料。采用SPSS 13.0软件进行分析。结果共收治AKI患儿121例,每年儿童AKI人数/每年因肾脏疾病住院人数呈递增趋势,其中70例患儿进行了肾活检。121例AKI患儿中,男79例,女42例,发病年龄1～14岁[(7.6±3.8)岁],临床诊断前4位分别为急性感染后肾炎,肾病综合征,溶血尿毒综合征和急性间质性肾炎;病理诊断前4位分别为系膜增生性肾小球肾炎,毛细血管内皮细胞增生性肾小球肾炎,间质性肾炎和狼疮肾炎。所有AKI患儿中61例行血液透析,5例行腹膜透析,其余患儿对症保守治疗后好转。治疗后完全康复95例(78.51%),部分康复24例(19.83%),维持性透析治疗2例(1.66%)。AKI衰竭期患儿住院时间(25.6±6.8)d,明显长于AKI危险期和损伤期患儿,且预后差。结论儿童AKI的病因以感染性疾病为主,尤以感染后肾小球肾炎和间质性肾炎为主,但狼疮肾炎有逐年增多趋势,易并发肾功能不全。肾实质性AKI患儿均应行肾活检以明确病因,进行有效治疗。早期诊断、及时治疗是改善AKI预后的关键。Objective To explore the prevalence,etiopathogenisis,pathological changes,course of disease turnover of acute kidney injury（AKI） in children. Methods The children who were diagnosed AKI in Department of Pediatric Nephrology,Shengjing Hospital of China Medical University from Sep.2005 to Sep.2010 were reviewed.The children were analyzed prevalence,clinical diagnosis,pathological diagnosis,length of stay and prognosis.SPSS 13.0 software were analyzed. Results A total of 121 children were included,including 79 boys and 42 girls,1 year to 14 years of age,mean age（7.6±3.8） years old.Seventy cases with renal biopsy.The amount of children with AKI was increased by years. Overall,acute glomerulonephritis was the major clinical diagnosis of AKI,followed by nephritic syndrome,hemolytic-uremic syndrome and acute tubulointerstitial nephritis.The main pathologic diagnosis included mesangial proliferative glomerulonephritis,endocapillary proliferative glomerulonephritis,tubulointerstitial nephritis and lupus nephritis.Hemodialysis was performed in 61 cases and peritoneal dialysis was performed in 5 cases,other patients were treated by conservative therapy. All 121 children were survived,95 patients（78.51%） with complete rehabilitation,24 patients（19.83%） with partial rehabilitation,2 patients（1.66%） needed maintenance dialysis.The length of stay for the patients with AKI（failure stage） were longer than those of patients with AKI（risk stage） and AKI（injury stage）. Conclusions Infection is the major cause of pediatric AKI,especially glomerulonephritis,tubulointerstitial nephritis.However,lupus nephritis patients are increased and followed AKI.All patients with AKI should be done renal biopsy to identify the causes.It is important to diagnose AKI in the early phase.

关 键 词：肾损伤 急性 病理 儿童 

分 类 号：R726.9[医药卫生—儿科]