肾脏疾病患儿伴急性肾损伤51例临床分析  

Clinical Analysis of 51 Children with Renal Disease with Acute Kidney Injury

作　　者：徐海霞[1] 李宇红[1] 蒋新辉 应蓓[1] 邱杰[1] 郑莎莎[1] 林俊[1] 邵晓珊[1] XU Hai-xia;LI Yu-hong;JING Xin-hui;YING Bei;QIU Jie;ZHENG Sha-sha;LIN Jun;SHAO Xiao-shan(Department of Renal Rheumatology, Guiyang Maternal and Child Health Hospital, Guiyang, Guizhou Province, 550003 China)

机构地区：[1]贵阳市妇幼保健院肾脏风湿免疫科

出　　处：《中外医疗》2019年第21期17-20,共4页China & Foreign Medical Treatment

基　　金：贵州省科技厅课题基金黔科合(LH[2015]7031);小儿急性肾损伤肾脏替代治疗时机选择研究;福棠儿童医学发展研究中心科研课题基金(201501);小儿急性肾损伤肾脏替代治疗时机选择研究

摘　　要：目的了解儿童肾脏疾病中急性肾损伤(Acute Kidney Injury,AKI)的发病率、病因、临床及病理特点、治疗效果,提高儿科医师对儿童肾脏疾病伴发AKI的认识。方法回顾性分析2013年1月-2016年7月该科肾脏疾病伴AKI患儿的临床资料。结果 51例AKI患儿纳入研究,占同期肾脏疾病的22.3%。男性29例,女性22例。发病年龄0.6~14.0岁[平均年龄(7.5±3.6)岁]。与非AKI病例相比,AKI组高血压、肉眼血尿比例更高,住院时间更长(P<0.05),两组治疗治愈/好转率差异无统计学意义(P>0.05)。AKI患儿主要病因是原发性肾病综合征(33.3%),急性链球菌感染后肾小球肾炎(25.5%),紫癜性肾炎(13.7%)。26例AKI患儿行肾活检,肾病理改变主要为毛细血管内增生性肾小球肾炎、紫癜性肾炎、局灶节段肾小球硬化、新月体肾炎。AKI患儿住院期间治愈/好转率84.3%,16例行肾脏替代治疗,与非肾脏替代治疗组预后差异无统计学意义(P>0.05)。结论儿童肾脏疾病中AKI发生率高,以肾小球性疾病居多,伴AKI的肾脏疾病患儿临床表现更重、肾病理损害严重,应早期识别,积极防治。Objective To investigate the incidence, etiology, clinical and pathological features and therapeutic effects of Acute Kidney Injury(AKI) in children with kidney disease, and to improve the understanding of pediatricians with AKI in children with kidney disease. Methods The clinical data of children with kidney disease and AKI in our department from January 2013 to July 2016 were retrospectively analyzed. Results 51 children with AKI were included in the study, accounting for 22.3% of kidney disease in the same period. There were 29 males and 22 females. The age of onset was 0.6 to 14.0 years old [mean age(7.5 ± 3.6) years old]. Compared with non-AKI cases, the AKI group had higher proportion of hypertension and gross hematuria and longer hospital stay(P<0.05). There was no statistically significant difference in the cure/reduction rate between the two groups(P>0.05). The main cause of AKI was primary nephrotic syndrome(33.3%), glomerulonephritis(25.5%) after acute streptococcal infection, and purpuric nephritis(13.7%). Renal biopsy was performed in 26 children with AKI. The renal pathological changes were mainly intraproliferative glomerulonephritis, purpuric nephritis, focal segmental glomerular sclerosis, and crescentic nephritis. The cure/return rate of children with AKI was 84.3% during hospitalization, and 16 patients underwent renal replacement therapy. There was no statistically significant difference between the two groups(P>0.05). Conclusion The incidence of AKI in children with kidney disease is high, and glomerular disease is the most common. Children with kidney disease with AKI have more severe clinical manifestations and serious renal pathological damage. They should be identified early and actively prevented.

关 键 词：肾脏疾病 临床分析 急性肾损伤 儿童 

分 类 号：R726.9[医药卫生—儿科]