临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (10): 740-.doi: 10.3969/j.issn.1000-3606.2020.10.005

• 综合报道 • 上一篇    下一篇

儿童激素耐药型肾病综合征基因变异及临床回顾性队列研究

蔡晓懿, 邓会英, 陈椰, 张佳仪, 李颖杰, 高霞   

  1. 广州市妇女儿童医疗中心肾内科(广东广州 510120)
  • 出版日期:2020-10-15 发布日期:2020-10-10
  • 通讯作者: 邓会英 电子信箱:xdenghuiying@126.com

A retrospective cohort study on gene variation and clinical features of steroid resistant nephrotic syndrome in children

CAI Xiaoyi, DENG Huiying, CHEN Ye, ZHANG Jiayi, LI Yingjie, GAO Xia   

  1. Department of Nephrology, Guangzhou Women and Children Medical Center, Guangzhou 510120, Guangdong, China
  • Online:2020-10-15 Published:2020-10-10

摘要: 目的 分析激素耐药型肾病综合征(SRNS)的基因变异及临床特点。方法 回顾分析2015年5月至2019年6 月诊断并行全外显子检测(WES)的58例SRNS患儿的临床资料,并比较有或无基因变异患儿之间临床指标、肾脏病理类 型、免疫抑制剂治疗缓解率及肾脏存活时间。结果 58例SRNS患儿中,男35例,女23例,发病年龄1个月~12岁。31例 检测出基因变异,以 WT1、NPHS1为主。31例有基因变异患儿发病初期合并肾功能不全的比例较27例无基因变异患儿明 显升高,差异有统计学意义(P<0.05)。 无基因变异患儿经免疫抑制剂治疗后完全缓解率为73.08%,显著高于有基因变 异患儿(41.18%),差异有统计学意义(P<0.05)。 有基因变异患儿的肾脏生存时间为(39.40±6.95)月,无基因变异患 儿为(58.90±4.87)月,差异有统计学意义(χ2=9.98, P<0.01)。 结论 SRNS患儿行基因检测对于病因诊断、治疗用药、 判断预后、肾移植后的复发预测有显著意义。

关键词: 激素耐药型肾病综合征; 基因检测; 儿童

Abstract: Objective? To?explore?the?gene?variation?and?clinical?characteristics?of?steroid?resistant?nephrotic?syndrome? (SRNS).?Methods? The?clinical?data?of?58?children?with?SRNS?diagnosed?by?whole?exon?sequencing?(WES)?from?May? 2015?to?June?2019?were?retrospectively?analyzed,?and?the?clinical?indicators,?renal?pathological?types,?remission?rate?of? immunosuppressive?therapy?and?renal?survival?time?were?compared?between?children?with?or?without?gene?mutation.?Results? In? 58?children?with?SRNS?(35?boys?and?23?girls),?the?age?at?onset?ranged?from?1?month?to?12?years.?Gene?variation?was?detected? in?31?cases,?mainly?WT1?and?NPHS1.?The?incidence?of?renal?insufficiency?in?31?cases?with?gene?mutation?was?significantly? higher?than?that?in?27?cases?without?gene?mutation?(P<0.05).?The?complete?remission?rate?of?children?without?gene?mutation?was? 73.08%,?which?was?significantly?higher?than?that?of?children?with?gene?mutation?(41.18%),?and?the?difference?was?statistically? significant?(P<0.05).?The?kidney?survival?time?of?children?with?genetic?mutation?was?(39.40±6.95)?months,?as?compared? with?(58.90±4.87)?months?in?children?without?genetic?mutation?was,?and?the?difference?was?statistically?significant?(χ2=9.98,? P<0.01).?Conclusion? Gene?detection?is?of?great?significance?in?etiological?diagnosis,?treatment,?prognosis?and?recurrence? prediction?after?renal?transplantation?in?children?with?SRNS.

Key words: steriod resistant nephrotic syndrome; genetic testing; child