摘要
目的 探讨肾病综合征 (NS)与结核病 (TB)之间的内在联系。方法 回顾分析自 1990年 1月至 2 0 0 1年 4月收治的 31例NS和TB同时存在的患儿 ,并对其相关资料行 χ2 检验统计学分析。结果 ①同期收治 6 94例NS患儿中有 31例 (占 4 47% )合并TB ;其中 17例合并肺结核的患儿中仅有 4例 (2 3 5 % )患儿有结核中毒症状 ;②二者同时存在时 ,同时应用抗结核药物及糖皮质激素或免疫抑制剂治疗NS的缓解率 (79 8% ) ,高于单纯应用糖皮质激素或免疫抑制剂治疗 (2 5 0 % ) (P <0 0 1) ,且前者结核感染向活动性结核的转化率低于后者 (分别为 0和 75 0 % ,P <0 0 1) ,部分病例单纯应用后者NS甚至不能缓解 ;③二者同时存在时NS的病理类型多样 ,以毛细血管内增生性肾小球肾炎为主。结论 ①NS与TB并存时应同时抗结核治疗 ,即使是结核感染也应预防性应用抗结核药物。②TB可能诱发NS ,且其病理类型多样 。
Objective To probe the inner relationship between nephrotic syndrome(NS) and tuberculosis(TB).Methods The patients contracted with NS and TB were studied retrospectively,and were analysised with chi-square test. Results ① Of 694 NS patients from Jan 1990 to April 2001,31 complicated TB ,accounting for 4.47%;Of the 31 patients ,only 23.5% with tuberculosis manifestations,such as fever ,cough, hemoptysis, night sweat, anorexia. ② The rate of remission of NS is higher in patients treated with antituberculosis drugs and steroids or immunosuppresive therapy concurrently than that of patients treated with steroids or immunosuppresive therapy only;Some of the later even couldn't achieve remisson.(79.8% vs 25.0% ,P<0.01).Of patients infected with tuberculosis, the deteriorative rate of TB is lower in patients treated with antituberculosis drugs and steroids or immunosuppresive therapy concurrently than that of patients treated with steroids or immunosuppresive therapy only.(0 vs 75.0%,P<0.01) ③The renal pathology of patients with NS and TB is varied,mainly endocapillary proliferative glomerulonephrtitis.Conclusion ① Patients with NS and TB should be treated with antituberculosis drugs and steroids or immunosuppresive therapy concurrently, even tuberculosis presented as tuberculosis infection. ② Tuberculosis could be the pathogenesis of NS ,and the renal pathology is varied,mainly endocapillary proliferative glomerulonephrtitis.
出处
《中国实用儿科杂志》
CSCD
北大核心
2002年第2期86-88,共3页
Chinese Journal of Practical Pediatrics
