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目的探讨急性肾小球肾炎(AGN)的流行病学、临床特征及转归。方法回顾性分析重庆医科大学附属儿童医院1996年1月-2005年12月697例AGN住院患儿的临床资料,分析其流行病学特点、前驱感染及病原学资料,并对其临床特征、病情、转归及预后进行综合分析。采用SPSS10.0软件进行统计学分析。结果AGN患儿697例占同期住院患儿的3.5‰,占泌尿系统疾病患儿的18.3%。一年四季均有发病,以11月~次年1月为发病高峰,8月份发病人数最少。一、二、三级亲属曾患AGN分别为24例(3.4%)、31例(4.4%)、2例(0.3%)。前驱感染中,405例(58.1%)为呼吸道感染,194例(27.8%)为皮肤感染,98例(14.1%)无明确前驱感染。呼吸道和皮肤感染至发病的间隔时间分别为(11.2±5.9)、(19.1±8.4)d。病原血清学检查中,抗链球菌溶血素(ASO)阳性检出率为66.7%、柯萨奇病毒(Cox)检出阳性率为53.6%,Cox抗体阳性的病例中57.8%并ASO增高。支原体抗体在2003-2005年检出率分别为0、18.8%、35.0%。697例中并严重循环充血21例(3.0%),高血压脑病36例(5.2%),急性肾功能不全42例(6.0%)。出院时治愈507例(72.7%),好转138例(19.8%),未愈51例(7.3%),死亡1例(0.1%)。结论链球菌仍是近10aAGN的重要病因。AGN在同期住院患儿中比例呈降低趋势,而并急性肾功能不全的发病率并未降低。
Objective To investigate the epidemiology, clinical characteristics and prognosis of acute glomerulonephritis (AGN). Methods The clinical data of 697 children with AGN hospitalized from January 1996 to December 2005 in Children’s Hospital of Chongqing Medical University were retrospectively analyzed. The epidemiological characteristics, precursor infection and etiological data were analyzed. The clinical features, , Outcome and prognosis of a comprehensive analysis. Using SPSS10.0 software for statistical analysis. Results 697 cases of children with AGN accounted for 3.5 ‰ of hospitalized children in the same period, accounting for 18.3% of children with urinary system diseases. Incidence all year round, in November to January next year peak incidence, the least number of onset in August. One, two, three relatives had AGN were 24 cases (3.4%), 31 cases (4.4%), 2 cases (0.3%). In the prodromal infection, 405 (58.1%) were respiratory infections, 194 (27.8%) were skin infections, and 98 (14.1%) had no clear precursor infection. Respiratory and skin infections to the time interval was (11.2 ± 5.9), (19.1 ± 8.4) d. In pathogenic serological tests, the positive rate of anti-streptolysin (ASO) was 66.7%, that of Cox was 53.6%, and that of Cox antibody was 57.8% and the ASO was higher. The detection rates of Mycoplasma antibodies in 2003-2005 were 0, 18.8% and 35.0% respectively. Among 697 cases, 21 cases (3.0%) had severe circulatory congestion, 36 cases (5.2%) had hypertensive encephalopathy, and 42 cases (6.0%) had acute renal insufficiency. At discharge, 507 cases (72.7%) were cured, 138 cases (19.8%) were cured, 51 cases were unhealed (7.3%) and 1 died (0.1%). Conclusion Streptococcus is still an important cause of nearly 10 000 AGN. AGN in hospitalized children in the same period showed a decreasing trend, but the incidence of acute renal insufficiency did not decrease.