中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
9期
46-48
,共3页
难治性肾病综合征%儿童%病理%临床分析
難治性腎病綜閤徵%兒童%病理%臨床分析
난치성신병종합정%인동%병리%림상분석
Refractory nephrotic syndrome%Chidren%Pathological type%Clinical analysis
目的 分析南阳地区儿童难治性肾病综合征的病理类型及临床资料,为临床诊断、治疗、预后提供可靠依据.方法 回顾性研究南阳市中心医院于2010年10月至2011年10月确诊难活性肾病综合征忠儿33例,将病理分型与临床诊断、治疗资料加以对比分析.结果 33例患儿中单纯性肾病10例,肾炎性肾病23例,病理类型中系膜增生性肾小球肾炎(MsPGN)占39.1％,微小病变肾小球病(MCD)占17.4％,局灶节段性硬化性肾小球肾炎(FSGS)及IgA肾病各占13.0％,膜增殖性紧肾小球肾炎及膜性肾痛(MN)各占8.7％.1例FSGS患儿及1例 MN 患儿要求转院失访,31例患儿明确病理类型后给予相应方案治疗,无严重并发症及药物不良反应发生.结论 难治性肾病患儿应适当早期行肾脏穿刺病理活检.南阳地区难治性肾病患儿病理类型以MsPGN及 MCD 最为常见,首选应用强的松2mg/( kg·d)+环磷酰胺8～12mg/(kg·d),连用2d,共6～8次方案治疗.
目的 分析南暘地區兒童難治性腎病綜閤徵的病理類型及臨床資料,為臨床診斷、治療、預後提供可靠依據.方法 迴顧性研究南暘市中心醫院于2010年10月至2011年10月確診難活性腎病綜閤徵忠兒33例,將病理分型與臨床診斷、治療資料加以對比分析.結果 33例患兒中單純性腎病10例,腎炎性腎病23例,病理類型中繫膜增生性腎小毬腎炎(MsPGN)佔39.1％,微小病變腎小毬病(MCD)佔17.4％,跼竈節段性硬化性腎小毬腎炎(FSGS)及IgA腎病各佔13.0％,膜增殖性緊腎小毬腎炎及膜性腎痛(MN)各佔8.7％.1例FSGS患兒及1例 MN 患兒要求轉院失訪,31例患兒明確病理類型後給予相應方案治療,無嚴重併髮癥及藥物不良反應髮生.結論 難治性腎病患兒應適噹早期行腎髒穿刺病理活檢.南暘地區難治性腎病患兒病理類型以MsPGN及 MCD 最為常見,首選應用彊的鬆2mg/( kg·d)+環燐酰胺8～12mg/(kg·d),連用2d,共6～8次方案治療.
목적 분석남양지구인동난치성신병종합정적병리류형급림상자료,위림상진단、치료、예후제공가고의거.방법 회고성연구남양시중심의원우2010년10월지2011년10월학진난활성신병종합정충인33례,장병리분형여림상진단、치료자료가이대비분석.결과 33례환인중단순성신병10례,신염성신병23례,병리류형중계막증생성신소구신염(MsPGN)점39.1％,미소병변신소구병(MCD)점17.4％,국조절단성경화성신소구신염(FSGS)급IgA신병각점13.0％,막증식성긴신소구신염급막성신통(MN)각점8.7％.1례FSGS환인급1례 MN 환인요구전원실방,31례환인명학병리류형후급여상응방안치료,무엄중병발증급약물불량반응발생.결론 난치성신병환인응괄당조기행신장천자병리활검.남양지구난치성신병환인병리류형이MsPGN급 MCD 최위상견,수선응용강적송2mg/( kg·d)+배린선알8～12mg/(kg·d),련용2d,공6～8차방안치료.
Objective To analyze the pathological types and clinical data of children with refractory nephrotic syndrome in Nanyang and provide reliable basis for clinical diagnosis,treatment and prognosis.Methods Thirty-three children with nephrotic syndrome from October 2010 to October 2011 were studied retrospectively,the pathological type,clinical diagnosis,treatment information were compared and analyzed.Results Among the 33 cases,simple nephrotic syndrome in 10cases,nephritis in 23 cases,pathological types of MsPGN accounted for 39.1％,MCD accounted for 17.4％,FSGS and IgAN each accounted for 13.0％,MPGN and MN each accounted for 8.7％.One patient with FSGS and 1 patient with MN request transfer loss,31 cases were given corresponding treatment after pathological types were definited.No serious complications or drug side effects occured.Conclusions Early renal biopsy should be done to children with refractory nephrotic.The most common pathological types of refractory nephrotic syndrome in Nanyang region are MsPGN and MCD,the preferred application was prednisone 2 mg/( kg · d) and cyclophosphamide 8 -12 mg/(kg · d),2 days every time,a total of 6 -8 times.
