儿童感染性心内膜炎肾脏损害临床特征分析  

Clinical and renal pathological findings in children infective endocarditis

作　　者：陈朝英[1] 刘景诚[3] 曹力[1] 季丽娜[1] 王琍[1] 石琳[2] 赵地[1] 

机构地区：[1]首都儿科研究所附属儿童医院内科,北京100020 [2]首都儿科研究所附属儿童医院病案科,北京100020 [3]北京大学第一医院儿科

出　　处：《中华全科医师杂志》2015年第1期43-46,共4页Chinese Journal of General Practitioners

摘　　要：回顾性分析1992年1月至2012年12月住院的儿童感染性心内膜炎（IE）伴肾脏损害患儿的临床表现、治疗和预后情况.结果显示,在确诊的23例IE患儿中,伴肾损害6例（26％）.肾损害表现为无症状镜下血尿1例、无症状蛋白尿1例、急性肾炎综合征4例;其中急性肾损伤3例,病因为肾小球肾炎、急性心力衰竭.两组主要临床症状、体征、实验室检查及合并症均差异无统计学意义,肾损害组血清C3下降率显著高于不伴肾损害组（P＜0.05）,两组患者均给予抗生素治疗并好转出院,肾损害组与不伴肾损害组的住院时间分别是（39.2±15.2）d、（34.9±19.2）d,差异无统计学意义（P＞0.05）.提示,儿童IE合并肾损害较为常见;在有效控制感染后,多数患儿肾损害恢复正常,伴急性肾损伤患儿预后较差.We retrospectively analyzed the clinical manifestations,treatments and prognosis of infective endocarditis （IE）associated with renal lesions in children.There were 23 confirmed IE cases who were admitted to the Capital Institutes of Pediatrics from 1992 to 2012.There were 6 cases （26%） with renal lesions.Renal lesions included asymptonatic microscopic hematuria（1 case）,asymptomatic proteinuria （1 case） and acute nephritic syndrome （4 cases）.There were 3 cases of acute renal injury （AKI） resulted from nephritis accompanied with acute heart failure.The serum level of C3 was lower in patients with renal lesions than patients without renal lesions （P 〈 0.05）,but the clinical manifestations,physical signs and other laboratory findings were the same.Patients of both groups were treated with antibiotics.All patients were recovered and discharged.The average hospital days were （39.2-± 15.2）days for patients with renal lesions and （34.9-± 19.2） days for patients without renal lesions （P 〉 0.05）.Renal lesions secondary to IE are relatively common in IE patients in children.Most of renal lesions can be improved by effective antibiotics.Prognosis of those patients accompanying with AKI is bad.

关 键 词：心内膜炎 肾疾病 

分 类 号：R725.4[医药卫生—儿科]