The Analysis Of Clinical Features Of Children With Nutcracker Syndrome In Different Age Groups

Objective: This paper aims to provide a reference for early detection and diagnosis of nutcracker by analyzing the clinical features of children with nutcracker syndrome in different age groups.Methods: Data of 112 children with simple NCS diagnosed in the Department of nephro of Chongqing children's hospital from January 2008 to January 2018 was analyzed retrospectively.Results: In children with nutcracker syndrome,girls accounted for63.4%,mainly in preschool age(82.4%),and boys accounted for36.6%,mainly in school age(48.5%)and adolescence(42.2%).There was a statistically significant difference that the average age of the boys is older than the girls(P<0.05).51.2% of boys presented with both hematuria and proteinuria,and the boys in adolescence had the highest incidence(68.4%).60.6% of girls presented with isolated hematuria,and the girls in preschool age had the highest incidence(82.1%),and the differences were statistically significant(P<0.05).Children in adolescence were most likelyto appear lumbar and abdominal pain,the incidence of boys was higher than girls,and the differences were statistically significant(P<0.05).There was a statistical difference that the detection rate of computed tomography angiography(CTA)(95.7%)was higher than color Doppler ultrasound(82.4%).The aortomesenteric angle(AMA)of the children with NCS in adolescence was smaller than that in preschool age and school age,and the ratio of the internal diameter of left renal vein(LRV)'s dilation part(a)to the stenosis part(b)(a/b)in adolescence was obviously larger than that in preschool age and school age,the difference were statistically significant(P<0.05).There was no statistical difference of hypodynamia,red blood cell count of 12 hours' urinary sediment,four urine proteins,serum creatinine(SCR),blood urea nitrogen(BUN),the distance of SMA and AA in the level of LRV(D1),the distance of LRV and SMA originating from AA,in different age or gender groups(P>0.05).By follow-up of 96 cases,there were 51 cases(58.0%)that urine examinations were back to normal in 88 cases that reexaminated urine,and 25 cases(46.3%)that the oppression of LRV under eased in 54 cases that reexaminated color Doppler ultrasound.Conclusion: There are more girls with NCS than boys,and girls are mainly in preschool age and always presented with isolated hematuria,while boys are mainly in school age and adolescence and always presented with both hematuria and proteinuria.Children inadolescence were most likely to appear lumbar and abdominal pain,and boys had a higher incidence rate than girls.The relatively older children have the relatively higher quantitation level of proteinuri,the smaller AMA and the larger a/b ratio,and it's especially obvious in adolescence.On the whole,this disease have a good prognosis.