背景:链球菌后肾小球肾炎是在感染某种链球菌菌株后发生的肾脏疾病。它有很高的住院率,尤其是在发展中国家。它的特点是突然出现水肿,血尿,蛋白尿,和高血压。这项回顾性描述性研究的目的是在奥隆阿波的詹姆斯·L·戈登纪念医院进行的,赞巴尔斯,菲律宾,是分析人口分布,临床表现,并发症,和急性链球菌感染后肾小球肾炎(APSGN)的结果。方法:在菲律宾一家三级医院的儿科病房进行了为期五年的诊断为链球菌性肾小球肾炎的患者(18岁以下)的回顾性描述性研究。所有患者均接受详细的临床病史和检查,并在治疗期间密切监测。密切监测和记录疾病进展的过程。
结果:77名儿童接受了APSGN治疗,平均年龄为7.8岁,标准差为3.85。53例(68.8%)和24例(31.1%)出现水肿和肉眼血尿,分别。高血压患者54例(70.1%)。在这54名患者中,49例(63.6%)患者出现急性肾损伤(基于年龄的肌酐正常),3例(3.8%)出现胸腔积液,2例(2.5%)出现高血压性脑病。所有患者都接受了KUB(肾脏,输尿管,和膀胱)超声,其中13例(16.88%)弥漫性实质肿胀好转,最终出院。60-65%的患者注意到血尿素氮(BUN)增加。低白蛋白血症和低血红蛋白也很常见。在治疗和住院期间没有死亡。
结论:APSGN仍然是该地区肾小球肾炎最常见的原因之一。水肿,高血压,血尿是最常见的表现特征。需要及早识别和全面监测和管理,以防止发病和死亡。如果进行早期治疗,预后通常良好。
BACKGROUND: Post-streptococcal
glomerulonephritis is a kidney disease that occurs after infection with a certain strain of streptococcal bacteria. It has a high hospitalization rate, especially in developing countries. It is characterized by the sudden appearance of edema, hematuria, proteinuria, and hypertension. The objective of this retrospective descriptive
study conducted at James L. Gordon Memorial Hospital in Olongapo, Zambales, Philippines, is to analyze the demographic distribution, clinical presentation, complication, and outcome of acute post-streptococcal glomerulonephritis (APSGN) in a pediatric population. Methods: A retrospective descriptive
study was done in patients (below 18 years of age) admitted with the diagnosis of post-streptococcal
glomerulonephritis during a five-year period in the pediatric ward of a tertiary hospital in the Philippines. All patients underwent detailed clinical history and examination and were closely monitored during treatment. The course of disease progression was closely monitored and recorded.
RESULTS: Seventy-seven children were treated for APSGN with a mean age of 7.8 years and with standard deviation of 3.85. Edema and gross hematuria were noted in 53 (68.8%) and 24 (31.1%) cases, respectively. Hypertension was present in 54 patients (70.1%). Among those 54 patients, 49 (63.6%) patients developed acute renal injury (based on normal creatinine for age), three cases (3.8%) had pleural effusion, and two patients (2.5%) developed hypertensive encephalopathy. All patients underwent KUB (kidneys, ureters, and bladder) ultrasound, among which 13 (16.88%) had diffuse parenchymal swelling which improved and eventually were discharged. Increased blood urea nitrogen (BUN) was noted in 60-65% of patients. Hypoalbuminemia and lower hemoglobin were also quite common. There was no mortality during treatment and hospital stay.
CONCLUSIONS: APSGN remains one of the most common causes of
glomerulonephritis in the region. Edema, hypertension, and hematuria were the most common presenting features. Early identification and comprehensive monitoring and management are required to prevent morbidity and mortality. The prognosis is generally good if early treatment is done.