临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (6): 412-.doi: 10.3969/j.issn.1000-3606.2017.06.004

• 泌尿系统疾病专栏 • 上一篇    下一篇

肾病综合征合并甲型H1N1 流感15 例临床研究

何庭艳1, 杨卫国2, 何颜霞2, 马颐姣1, 杨军1   

  1. 深圳市儿童医院1 . 肾脏免疫科,2 . 重症监护室(广东深圳 518038)
  • 收稿日期:2017-06-15 出版日期:2017-06-15 发布日期:2017-06-15
  • 通讯作者: 杨军 E-mail:rogasansz@163 .com
  • 基金资助:
    深圳市卫生计生项目(No. 201606036)

Clinical analysis of nephrotic syndrome combined with H1N1 influenza in 15 children

 HE Tingyan1, YANG Weiguo2, HE Yanxia2, MA Yijiao1, YANG Jun1   

  1. 1. Department of Kidney and Immunology; 2. Pediatric Intensive Care Unit, Shenzhen Children's Hospital, Shenzhen 518038, Guangdong, China
  • Received:2017-06-15 Online:2017-06-15 Published:2017-06-15

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 explore the clinical features of nephrotic syndrome combined with H1N1 influenza. Methods The clinical manifestations, laboratory and image examinations, treatment, and prognosis of nephrotic syndrome combined H1N1 influenza were retrospectively analyzed in 15 children with. Results All of 15 children with nephrotic syndrome met the diagnostic criteria of H1N1 influenza. The median age of all children was 4-year-8-month old (2-year-2-month to 6-year-9month). All children were treated with hormone alone or combined with other immunosuppressive drugs. Three cases were severe and another 5 cases were critically ill. Four cases were complicated with recurrence of nephrotic syndrome, 2 of which suffered from acute renal insufficiency. All children were given oseltamivir as antiviral treatment at admission. Four cases took oseltamivir within 48 hours of onset and showed mild symptoms. Fourteen children with H1N1I influenza were cured, their urinary proteins were significantly decreased or converted to negative, and the median hospital stay was 8 days (1 to 25 days). One child died of acute necrotizing encephalopathy and brain herniation. Conclusions Children with nephrotic syndrome are susceptible to severe or critical H1N1 influenza infections. During the epidemic of H1N1 influenza, the clinical preventive measures should be taken in children with nephrotic syndrome.