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目的 :认识肾功能衰竭 (肾衰 )危险的预告指标和对严重的儿童狼疮肾炎应积极治疗的重要性。方法 :对 10 6例狼疮肾炎病儿的记载 ,进行回顾性分析。结果 :有 2 4例病儿发展至慢性肾衰。持续性高血压、贫血、尿常规异常和血清肌酐升高是发展至肾衰的预告指标 ,其中 10例进行了肾活检 ,根据WHO标准进行分类 ,4例Ⅳ型中 3例有较严重的小管间质及血管损害 ,均进入肾衰。 2 4例肾衰病儿 ,9例在开始透析的mo 1内死亡 ,7例暴发狼疮死亡 ,8例慢性透析者 ,5例死于败血症。结论 :对有进入肾衰预告指标的病儿应采取环磷酰胺冲击联合泼尼松的治疗方案
OBJECTIVES: To recognize the predisposing indicators of the risk of renal failure (renal failure) and the importance of active treatment for severe lupus nephritis in children. Methods: The records of 106 children with lupus nephritis were retrospectively analyzed. Results: 24 children developed chronic renal failure. Persistent hypertension, anemia, urinary abnormalities, and elevated serum creatinine are predictive indicators of progression to renal failure, 10 of whom underwent renal biopsy and were classified according to the WHO criteria, and 3 of 4 patients with type IV had more severe tubules Interstitial and vascular damage, have entered the renal failure. Twenty-four children with renal failure, nine died within mo 1 on dialysis, seven died of lupus, eight had chronic dialysis, and five died of sepsis. CONCLUSIONS: Treatment of cyclophosphamide-associated prednisone should be taken for children who have entered the index of renal failure