The Analysis Of The Clinical Characteristics And Relapsing Related Factors Of Primary Nephrotic Syndrome In Children Of Newly Diagnosed

Objective Through the summary and analysis of clinical data and laboratory examination indexes,including age,gender,blood biochemistry,immune function,urinary protein,and relapsing condition of primary nephrotic syndrome(PNS)in children before glucocorticoid therapy,clinical characteristics and the relapsing relevant factors of PNS were discussed to provide help for clinician’s diagnosis and treatment.Methods(1)Collected the clinical data,laboratory examination indexes and relapsing condition after one year of follow-up of the PNS in children before glucocorticoid therapy during January 2012 to December 2018 in the first affiliated hospital of guangxi medical university,171 cases were collected,including 105 cases without relapse,66 cases of relapse.(2)The SPSS 24.0software was used for data analysis.Frequency and percentage,mean±standard deviation(Median,upper and lower quartiles were used in the skewed distribution data)were respectively used for classification data and quantitative data.Chi-square test and independent sample t test were used for single-factor analysis(Wilcoxon rank-sum test was used for skewed distribution data).Multivariate logistic regression model was used for influence factor analysis.The variables of P<0.15 in the single-factor analysis were selected into the multivariate logistic model,and the variables were selected by using the LR regression method.Results(1)Among the 171 cases of newly diagnosed with PNS,the average age of onset was 5.5±3.04 years,mainly in preschool age.131(76.6%)cases were males,and 40(23.4%)cases were females,male:female=3.3:1.(2)Among the 171 cases of newly diagnosed with PNS,all had edema of varying degrees,29(16.95%)cases had hematuria,and 22(12.87%)cases had hypertension.There were 143(83.6%)cases of simple type NS,28(16.4%)cases of nephritis type NS,simple type NS:nephritis type NS=5.1:1.(3)Among the171 cases of newly diagnosed with PNS,all had hypoalbuminemia and hyperlipidemia,and 108(63.16%)cases had heavy proteinuria.Other abnormal laboratory examination indexes were electrolyte disorder(97.66%),erythrocyto sedimentation rate increased(97.66%),Ig G decreased(97.07%),fibrinogen increased(95.32%),NK cells decreased(80.12%),CD4~+cells increased(20.47%),CD8~+cells increased(22.81%),etc.(4)Among the 171 cases of newly diagnosed with PNS,137(80.12%)cases were concurrent infection.126(91.97%)cases were respiratory tract infection,and 80(63.49%)cases were lower respiratory tract infection.In terms of pathogens,mycoplasma pneumoniae was the most common pathogen(13.45%).Other pathogens had mycobacterium tuberculosis(5.26%),etc.(5)Correlation analysis:There were no significant difference in onset age,gender,plasma albumin,urea nitrogen,serum creatinine,uric acid,endogenous creatinine clearance rate,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,fibrinogen,D-dimer,Ig A,Ig G,Ig M,total T cells,CD4~+cells,CD8~+cells,NK cells,complement C3,complement C4,erythrocyto sedimentation rate,bloodβ2 microglobulin,urineβ2 microglobulin,24 hours urinary protein quantitative of the children before glucocorticoid therapy at the time of onset between the relapsing group and without relapsing group(P>0.05).The clinical typing and infection at the time of onset had significant difference between the relapsing group and without relapsing group(P<0.05).Conclusion(1)In this group,the preschool period was the most common onset age of PNS,the incidence of boys was significantly more than that of girls.(2)The simple type NS was the mainly clinical typing.(3)Clinical typing and infection at the time of onset are the risk factors of relapse of PNS.