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目的探讨儿童胡桃夹现象的临床特点及伴随因素。方法研究对象为2004年9月至2007年9月收治于中国医科大学附属盛京医院儿肾病房的70例胡桃夹现象患儿,完善相关化验检查,分析其临床特点。结果70例胡桃夹现象仅有11例为单纯胡桃夹现象,占15.7%。38例为感染后肾炎伴胡桃夹现象,占54.2%,其中,20例有肺炎支原体感染,5例为急性链球菌感染,13例感染源不明,25例病理为轻-中度系膜增生性肾炎。9例为IgA肾病伴胡桃夹现象,占12.9%。9例为过敏性紫癜肾炎伴胡桃夹现象,占12.9%,有5例同时存在肺炎支原体感染。3例为泌尿系感染伴胡桃夹现象,占4.3%,1例为出血性膀胱炎,2例为下尿路感染,其中1例伴有肺炎支原体感染。结论诊断左肾静脉受压综合征时,应注意儿童器质性肾脏疾病,必要时应及早做肾活检确诊,防止误诊。
Objective To explore the clinical characteristics and accompanying factors of children’s nutcracker phenomenon. Methods The subjects were 70 cases of Nutcracker children admitted to the pediatric nephrology ward of Shengjing Hospital of China Medical University from September 2004 to September 2007, and to improve the relevant laboratory tests and analyze the clinical features. Results 70 cases of nutcracker phenomenon only 11 cases of simple nutcracker phenomenon, accounting for 15.7%. 38 cases were infected with nephritis with Nutcracker phenomenon, accounting for 54.2%, of which 20 cases were Mycoplasma pneumoniae infection, 5 cases of acute streptococcal infection, 13 cases of unknown origin, 25 cases of pathological mild to moderate mesangial proliferative Nephritis. 9 cases of IgA nephrosis with Nutcracker phenomenon, accounting for 12.9%. 9 cases of allergic purpura nephritis with Nutcracker phenomenon, accounting for 12.9%, 5 cases of Mycoplasma pneumoniae infection. 3 cases of urinary tract infection with Nutcracker phenomenon, accounting for 4.3%, 1 case of hemorrhagic cystitis, 2 cases of lower urinary tract infection, including 1 case of Mycoplasma pneumoniae infection. Conclusion Diagnosis of left renal vein compression syndrome should pay attention to organic kidney disease in children, if necessary, early diagnosis of renal biopsy should be done to prevent misdiagnosis.