中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
7期
486-490
,共5页
全国儿童常见肾脏病诊治现状调研工作组
全國兒童常見腎髒病診治現狀調研工作組
전국인동상견신장병진치현상조연공작조
肾小球肾炎,IGA%临床方案%多中心研究%儿童
腎小毬腎炎,IGA%臨床方案%多中心研究%兒童
신소구신염,IGA%림상방안%다중심연구%인동
Glomerulonephritis,IGA%Clinical protocols%Multicenter study%Child
目的 中国儿童IgA肾病治疗现状尚不明确,本研究探讨中国儿童IgA肾病治疗现状,为本病的治疗以及进一步研究提供基本数据.方法 由中华医学会儿科学分会肾脏病学组组织全国多家三级甲等医院,对2008年7月1日至2011年6月30日收治的18岁及以下经肾脏病理确诊的IgA肾病患儿进行调查,收集一般信息、临床表型及治疗状况,分析治疗状况.结果 共35家三级甲等医院参加了此次调研,共纳入1417例,男952例(67.2％),女465例(32.8％),年龄0.5～18.0岁,中位年龄10.0岁.临床表型依次为血尿和蛋白尿型524例(37.0％)、肾病综合征型433例(30.6％)、孤立性血尿型224例(15.8％)、急性肾小球肾炎型180例(12.7％)、慢性肾小球肾炎型26例(1.8％)、急进性肾小球肾炎19例(1.3％)、孤立性蛋白尿11例(0.8％).血尿和蛋白尿型的主要用药依次为血管紧张素转换酶抑制剂(ACEI)和(或)血管紧张素受体拮抗剂(ARB)类药物(49.6％)、口服激素(41.4％)、静脉甲泼尼龙(20.8％)、雷公藤制剂(18.7％)、环磷酰胺(11.3％)等.肾病综合征型的主要用药依次为口服激素(76.2％)、ACEI和(或)ARB类药物(60.5％)、环磷酰胺(40.0％)、静脉甲泼尼龙(31.2％)和雷公藤制剂(10.6％)等.结论 本研究为国内首次进行的全国范围儿童IgA肾病治疗现状调研,对于肾病综合征型的治疗分别以激素、ACEI和(或)ARB和环磷酰胺为主,激素和免疫抑制剂对于其他类型IgA肾病的应用和适应证有待研究.
目的 中國兒童IgA腎病治療現狀尚不明確,本研究探討中國兒童IgA腎病治療現狀,為本病的治療以及進一步研究提供基本數據.方法 由中華醫學會兒科學分會腎髒病學組組織全國多傢三級甲等醫院,對2008年7月1日至2011年6月30日收治的18歲及以下經腎髒病理確診的IgA腎病患兒進行調查,收集一般信息、臨床錶型及治療狀況,分析治療狀況.結果 共35傢三級甲等醫院參加瞭此次調研,共納入1417例,男952例(67.2％),女465例(32.8％),年齡0.5～18.0歲,中位年齡10.0歲.臨床錶型依次為血尿和蛋白尿型524例(37.0％)、腎病綜閤徵型433例(30.6％)、孤立性血尿型224例(15.8％)、急性腎小毬腎炎型180例(12.7％)、慢性腎小毬腎炎型26例(1.8％)、急進性腎小毬腎炎19例(1.3％)、孤立性蛋白尿11例(0.8％).血尿和蛋白尿型的主要用藥依次為血管緊張素轉換酶抑製劑(ACEI)和(或)血管緊張素受體拮抗劑(ARB)類藥物(49.6％)、口服激素(41.4％)、靜脈甲潑尼龍(20.8％)、雷公籐製劑(18.7％)、環燐酰胺(11.3％)等.腎病綜閤徵型的主要用藥依次為口服激素(76.2％)、ACEI和(或)ARB類藥物(60.5％)、環燐酰胺(40.0％)、靜脈甲潑尼龍(31.2％)和雷公籐製劑(10.6％)等.結論 本研究為國內首次進行的全國範圍兒童IgA腎病治療現狀調研,對于腎病綜閤徵型的治療分彆以激素、ACEI和(或)ARB和環燐酰胺為主,激素和免疫抑製劑對于其他類型IgA腎病的應用和適應證有待研究.
목적 중국인동IgA신병치료현상상불명학,본연구탐토중국인동IgA신병치료현상,위본병적치료이급진일보연구제공기본수거.방법 유중화의학회인과학분회신장병학조조직전국다가삼급갑등의원,대2008년7월1일지2011년6월30일수치적18세급이하경신장병리학진적IgA신병환인진행조사,수집일반신식、림상표형급치료상황,분석치료상황.결과 공35가삼급갑등의원삼가료차차조연,공납입1417례,남952례(67.2％),녀465례(32.8％),년령0.5～18.0세,중위년령10.0세.림상표형의차위혈뇨화단백뇨형524례(37.0％)、신병종합정형433례(30.6％)、고립성혈뇨형224례(15.8％)、급성신소구신염형180례(12.7％)、만성신소구신염형26례(1.8％)、급진성신소구신염19례(1.3％)、고립성단백뇨11례(0.8％).혈뇨화단백뇨형적주요용약의차위혈관긴장소전환매억제제(ACEI)화(혹)혈관긴장소수체길항제(ARB)류약물(49.6％)、구복격소(41.4％)、정맥갑발니룡(20.8％)、뢰공등제제(18.7％)、배린선알(11.3％)등.신병종합정형적주요용약의차위구복격소(76.2％)、ACEI화(혹)ARB류약물(60.5％)、배린선알(40.0％)、정맥갑발니룡(31.2％)화뢰공등제제(10.6％)등.결론 본연구위국내수차진행적전국범위인동IgA신병치료현상조연,대우신병종합정형적치료분별이격소、ACEI화(혹)ARB화배린선알위주,격소화면역억제제대우기타류형IgA신병적응용화괄응증유대연구.
Objective Data of general status of clinical presentation and therapy of IgA nephropathy in children in China are lacking.This study aimed to investigate the clinical presentations and treatment status of children with IgA nephropathy in China.Method The investigation was organized by Chinese Society of Pediatric Nephrology.Thirty five centers from 23 provinces/municipalities of China participated in the study.Children no more than 18 years old who were diagnosed by renal biopsy as IgA nephropathy from July 1,2008 to June 20,2011 were included.The data on clinical presentations and treatment methods were collected.Descriptive method was used for data analysis.Result Totally 1417 children aged from 0.5 to 18 years old were included.The median age was 10.0 years old.Children more than 6 years old accounted for 89.8％.Most of the children presented with hematuria and proteinuria (37.0％),nephrotic syndrome type accounted for 30.6％,isolated hematuria type accounted for 15.8％,acute glomerulonephritis type accounteed for 12.7％,chronic glomerulonephritis type accounted for 1.8％,acute rapidly progressive glomerulonephritis type accounted for 1.3％,isolated proteinuria type accounted for 0.8％.The common drug used for children with hematuria and proteinuria type included angiotensin-converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor antagonists (ARB) (49.6％),oral prednisone (41.4％),intravenous methylprednisolone (20.8％),etc.The therapies with oral prednisone (76.2％),ACEI/ARB (60.5％),cyclophosphamide (40.0％),intravenous methylprednisolone (31.2％) were more often used for children with nephrotic syndrome type.Conclusion This is the first nationwide investigation on therapy status of children with IgA nephropathy in China.Steroid combined with ACEI/ARB and cyclophosphamide was the main treatment for children with nephrotic syndrome type.The effect of steroid combined with immunosuppressant on other types of IgA nephropathy needs further investigation.
