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目的:探讨儿童原发性肾病综合征(primarynephrotic syndrome,PNS)经激素治疗后尿蛋白转阴时间的影响因素。方法:回顾性分析68例初发PNS患儿的临床资料,通过激素治疗后,按照尿蛋白转阴时间进行分组,对患儿特征、化验指标进行单因素分析和多因素非条件Logistic回归分析。结果:单因素分析显示水肿至口服激素时间、水肿程度、父母认知程度、有无合并感染、入院时血浆IgM水平、白蛋白水平、胶体渗透压等指标在不同预后组间有显著性差异(P<0.05)。多因素分析显示水肿至口服激素时间长、父母认知程度差、血浆胶体渗透压低可视为尿蛋白转阴时间大于1周的危险因素。结论:水肿至口服激素时间长、父母认知程度差、血浆胶体渗透压低为PNS患儿尿蛋白转阴时间长于1周的危险因素,与患儿的不良预后相关,临床应予以高度重视。
Objective: To investigate the influencing factors of urinary protein in children with primary nephrotic syndrome (PNS) after hormone therapy. Methods: The clinical data of 68 infants with newly diagnosed PNS were retrospectively analyzed. After steroid treatment, they were grouped according to urinary protein negative conversion time. Univariate analysis and multivariate non-conditional Logistic regression analysis were performed on children’s characteristics and laboratory parameters. Results: Univariate analysis showed that edema to oral hormone time, degree of edema, degree of parental cognition, presence or absence of co-infection, plasma IgM level, albumin level and colloid osmotic pressure on admission were significantly different among different prognostic groups P <0.05). Multivariate analysis showed that edema to oral hormones for a long time, poor cognitive status of parents, plasma colloid osmotic pressure can be considered as urine protein negative conversion time of more than 1 week risk factors. Conclusion: Edema to oral hormone for a long time, poor cognitive status of parents, low plasma colloid osmotic pressure in children with PNS negative urine protein over longer than 1 week risk factors, and children with poor prognosis, the clinical should be highly valued.