肾病综合征合并甲型H1N1流感15例临床研究

发布时间：2018-03-04 19:27

本文选题：甲型HN流感　切入点：肾病综合征　出处：《临床儿科杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨肾病综合征合并甲型H1N1流感的临床特点。方法回顾分析15例肾病综合征合并甲型H1N1流感患儿的临床表现、实验室及影像学检查、治疗措施及预后。结果 15例确诊肾病综合征患儿均符合甲型H1N1流感诊断标准。患儿中位年龄4岁8个月(2岁2个月~6岁9个月),均单用激素或联合其他免疫抑制剂治疗;重症患儿3例,危重型患儿5例。4例患儿的肾病综合征全面复发,其中2例并发急性肾功能不全。所有患儿在入院时均给予奥司他韦抗病毒治疗,4例在起病48 h内使用奥司他韦,该4例患儿均表现为普通型甲型H1N1流感。14例患儿的甲型H1N1流感治愈出院,尿蛋白明显好转或转阴,中位住院时间8天(1~25天);1例患儿死亡,死于急性坏死性脑病、脑疝。结论肾病综合征患儿是重症或危重型甲型H1N1流感的高危人群,甲型H1N1流感流行期,应对肾病综合征患儿采取临床预防措施。
[Abstract]:Objective to investigate the clinical features of nephrotic syndrome with influenza A (H1N1). Methods the clinical manifestations, laboratory and imaging findings of 15 children with nephrotic syndrome complicated with influenza A (H1N1) were retrospectively analyzed. Results all the 15 children with confirmed nephrotic syndrome met the diagnostic criteria of influenza A (H1N1). The median age was 4 years, 8 months, 2 months, 2 months, 2 months, 6 years, 9 months, all patients were treated only with hormones or other immunosuppressants. Nephrotic syndrome recurred in 3 cases of severe children and 5 cases of critical type. All the patients were treated with oseltamivir antiviral therapy on admission, 4 patients were given oseltamivir within 48 hours after the onset of the disease. All the 4 cases showed common A (H1N1) influenza. 14 cases were cured and discharged, urine protein was obviously improved or turned negative, and 1 case died of acute necrotic encephalopathy after a median hospitalization of 8 days or 25 days. Conclusion Nephrotic syndrome is a high risk group of severe or critical influenza A (H1N1). During influenza A (H1N1) epidemic period, clinical preventive measures should be taken for children with nephrotic syndrome.
【作者单位】：深圳市儿童医院肾脏免疫科;深圳市儿童医院重症监护室;
【基金】：深圳市卫生计生项目(No.201606036)
【分类号】：R725.1;R726.9

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