【摘要】：目的探討兒童原發(fā)性局灶節(jié)段性腎小球硬化(FSGS)塌陷型和經(jīng)典型的遠期預(yù)后及影響因素。方法回顧分析兒童塌陷型和經(jīng)典型FSGS的臨床、病理及隨訪資料,并對其進行Kaplan-Meier法分析、單因素和多因素Cox回歸分析。結(jié)果經(jīng)腎活檢結(jié)合臨床表現(xiàn)確診的FSGS患兒中塌陷型29例、經(jīng)典型35例。塌陷型和經(jīng)典型4年腎臟存活率分別為48.3%和74.3%。Kaplan-Merier生存分析顯示塌陷型中位腎生存時間(25.41±3.28)月,經(jīng)典型中位腎生存時間(35.53±2.73)月,兩者差異有統(tǒng)計學(xué)意義(χ2=4.07,P=0.044)。多因素Cox回歸分析顯示,對治療反應(yīng)差(HR=5.92,95%CI:1.35~25.85)及早期出現(xiàn)腎功能不全(HR=2.45,95%CI:1.03~5.84)是影響預(yù)后的獨立危險因素。結(jié)論兒童塌陷型FSGS較經(jīng)典型有更嚴重的蛋白尿、腎功能損傷以及更差的治療反應(yīng),對這些因素進行校正后兩者的預(yù)后無顯著差異,對治療反應(yīng)差和早期腎功能損傷患兒的預(yù)后較差。
[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 鹵3.28) months, and that of the classical type was (35.53 鹵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.
【作者單位】： 廣州婦女兒童醫(yī)療中心腎內(nèi)科;
【分類號】：R726.9

【相似文獻】

相關(guān)期刊論文 前4條

1 吳攀;;100例兒童急性淋巴細胞白血病患者的預(yù)后及生存分析[J];中國衛(wèi)生產(chǎn)業(yè);2013年29期

2 杜娟;沈穎;;兒童慢性腎衰竭多因素Cox生存分析[J];臨床兒科雜志;2010年04期

3 宋亮;劉華林;孫立榮;劉瑞海;鐘任;趙艷霞;;影響兒童急性淋巴細胞白血病預(yù)后的多因素分析[J];中國小兒血液與腫瘤雜志;2010年01期

4 ;[J];;年期

相關(guān)會議論文 前1條

1 雷治宇;湯永民;徐曉軍;宋華;楊世隆;石淑文;徐衛(wèi)群;;兒童急性淋巴細胞白血病長期隨訪及預(yù)后分析[A];2013年國家級“惡性血液系統(tǒng)疾病診治新進展”學(xué)習(xí)班暨學(xué)術(shù)年會資料匯編[C];2013年

相關(guān)博士學(xué)位論文 前1條

1 雷治宇;247例兒童急性淋巴細胞白血病長期隨訪及預(yù)后分析[D];浙江大學(xué);2013年

，

本文編號：2174789