大量蛋白尿表现的儿童急性链球菌感染后肾小球肾炎临床分析  

Clinical Analysis of Acute Post-Streptococcal Glomerulonephritis in Children with Massive Proteinuria

作　　者：李志辉 熊冰瑶 康志娟 吴天慧 寻劢 Li Zhihui;Xiong Bingyao;Kang Zhijuan;Wu Tianhui;Xun Mai(Academy of Pediatrics of University of South China,Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]南华大学儿科学院,湖南省儿童医院,长沙410007

出　　处：《儿科药学杂志》2022年第8期39-43,共5页Journal of Pediatric Pharmacy

摘　　要：目的:探讨大量蛋白尿表现的儿童急性链球菌感染后肾炎(APSGN)病情迁延的危险因素,为儿童慢性肾脏病防治提供参考。方法:收集2007年2月至2018年12月在湖南省儿童医院肾内科住院的具有大量蛋白尿表现的APSGN患儿资料,根据蛋白尿持续时间是否<3个月分为Ⅰ组和Ⅱ组,分析两组患儿临床及病理因素的差异,并采用Logistic回归分析蛋白尿持续时间延长的危险因素。结果:收集患儿119例,其中男84例,女35例,年龄(9.39±2.80)岁。两组患儿高血压、急性肾损伤、肾脏C1q沉积发生率及血C4水平比较,差异有统计学意义(P<0.05);Logistic回归分析显示,高血压、低水平血C4是蛋白尿持续时间延长的危险因素(P<0.05)。结论:高血压、低水平血C4是大量蛋白尿表现的APSGN患儿病情迁延的危险因素,需警惕发展为慢性肾脏病。Objective:To explore the risk factors of acute post-streptococcal glomerulonephritis(APSGN)in children with massive proteinuria,so as to provide reference for the prevention and treatment of chronic kidney disease in children.Methods:Data of APSGN children with massive proteinuria admitted into the nephrology department of Hunan Children’s Hospital from Feb.2007 to Dec.2018 were extracted,and all patients were divided into the groupⅠand groupⅡaccording to whether the duration of proteinuria was less than 3 months.Differences of clinical and pathological factors between two groups were analyzed,and risk factors of prolonged duration of proteinuria were analyzed by Logistic regression.Results:A total of 119 children were enrolled,including 84 males and 35 females,aged(9.39±2.80)years old.There were statistically significant differences in the incidence of hypertension,acute kidney injury,renal C1 q deposition and blood C4 level between two groups(P<0.05).Logistic regression analysis showed that hypertension and low blood C4 level were risk factors for prolonged duration of proteinuria(P<0.05).Conclusion:Hypertension,low blood C4 level are risk factors for the progression of APSGN in children with massive proteinuria,which should be vigilant for the development of chronic kidney disease.

关 键 词：急性肾小球肾炎 链球菌感染 儿童 大量蛋白尿 蛋白尿持续时间 

分 类 号：R725.9[医药卫生—儿科]