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目的:观察急性链球菌感染后肾炎(APSGN)患儿血压变化规律。方法:观察15例重型APSGN(重型组)和20例普通型APSGN(普通组)患儿病程中各时期血压及尿量变化,并进行免疫和生化指标对比。结果:APSGN患儿高血压总共26例(74.29%),其中重症组高血压14例(93.3%),普通组高血压12例(60%),高血压发生率重症组高于普通组P<0.05。重症APSGN患儿入院时舒张压、少尿期收缩压舒张压、多尿期舒张压与普通组比较均有显著性差异,P<0.05;而且重症APSGN与普通组在少尿期持续时间、尿量、多尿期持续时间、尿量的指标比较也均有显著性差异,P<0.05。重症APSGN患儿血IgG、BUN、Cr明显高于普通APSGN,P<0.05。结论:高血压是APSGN主要临床表现之一,血压增高多发生于少尿期,但重症APSGN患儿于多尿期出现血压增高的第二次高峰,临床上应注意监测,及时治疗。
Objective: To observe the changes of blood pressure in children with acute streptococcal nephritis (APSGN). Methods: The changes of blood pressure and urine volume in 15 APSGN (severe group) and 20 APSGN (general group) patients during the course of the disease were observed, and the comparison of the immune and biochemical indexes was made. Results: A total of 26 patients (74.29%) had hypertension in APSGN, including 14 cases (93.3%) in severe group and 12 cases (60%) in common group. The incidence of hypertension in severe group was higher than that in general group (P < 0.05. Diastolic blood pressure, systolic diastolic pressure in oliguria phase and diastolic blood pressure in polyuria group were significantly different in severe APSGN children at admission (P <0.05), and those in severe APSGN group were significantly higher than those in common group Volume, duration of polyuria, urine volume indicators were also significantly different, P <0.05. Serum IgG, BUN and Cr in children with severe APSGN were significantly higher than those in common APSGN, P <0.05. Conclusions: Hypertension is one of the main clinical manifestations of APSGN. The increase of blood pressure occurs mostly in the oliguria stage. However, the second peak of blood pressure in patients with severe APSGN in polyuria should be monitored and treated promptly.