儿童塌陷型局灶节段性肾小球硬化预后分析

发布时间：2018-08-09 17:25

【摘要】：目的探讨儿童原发性局灶节段性肾小球硬化(FSGS)塌陷型和经典型的远期预后及影响因素。方法回顾分析儿童塌陷型和经典型FSGS的临床、病理及随访资料,并对其进行Kaplan-Meier法分析、单因素和多因素Cox回归分析。结果经肾活检结合临床表现确诊的FSGS患儿中塌陷型29例、经典型35例。塌陷型和经典型4年肾脏存活率分别为48.3%和74.3%。Kaplan-Merier生存分析显示塌陷型中位肾生存时间(25.41±3.28)月,经典型中位肾生存时间(35.53±2.73)月,两者差异有统计学意义(χ2=4.07,P=0.044)。多因素Cox回归分析显示,对治疗反应差(HR=5.92,95%CI:1.35~25.85)及早期出现肾功能不全(HR=2.45,95%CI:1.03~5.84)是影响预后的独立危险因素。结论儿童塌陷型FSGS较经典型有更严重的蛋白尿、肾功能损伤以及更差的治疗反应,对这些因素进行校正后两者的预后无显著差异,对治疗反应差和早期肾功能损伤患儿的预后较差。
[Abstract]:Objective to investigate the long-term prognosis and influencing factors of primary focal segmental glomerulosclerosis (FSGS) collapse type and classical type in children. Methods the clinical pathological and follow-up data of collapsed and classical FSGS in children were analyzed retrospectively and analyzed by Kaplan-Meier and univariate and multivariate Cox regression analysis. Results 29 cases of collapse type and 35 cases of classical type were diagnosed by renal biopsy combined with clinical manifestation. 74.3%.Kaplan-Merier survival analysis showed that the median survival time of the collapsed kidney was (25.41 卤3.28) months, and that of the classical type was (35.53 卤2.73) months. The difference between the two groups was statistically significant (蠂 ~ (2 +) 4.07) P ~ (0.044). Multivariate Cox regression analysis showed that poor response to treatment (HR5. 92% CI: 1. 35% 25. 85) and early renal insufficiency (HR2. 45% 95 CI: 1. 03% 5. 84) were independent risk factors for prognosis. Conclusion FSGS in children has more serious proteinuria, renal function injury and worse therapeutic response than the classical one. There is no significant difference in prognosis between the two groups after adjusting for these factors. The prognosis of children with poor response to treatment and early renal function injury was poor.
【作者单位】：广州妇女儿童医疗中心肾内科;
【分类号】：R726.9

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