儿童常见呼吸道病原体感染与肾脏损伤.pdfVIP

中华实用儿科临床杂志2016年3月第31卷第5期 Chin J Appl Clin Pediatr，March2016，Vol.31，No.5 ·329 · ·专家论坛· 儿童常见呼吸道病原体感染与肾脏损伤 李羚 郭赟 214023 南京医科大学附属无锡市人民医院儿童医院呼吸科 Email：sy333345@163.com 通信作者：李羚， DOI：10.3760/ cma.j.issn.2095 428X.2016.05.003 【摘要】 细菌、病毒和肺炎支原体等是引起儿童肾脏损伤的常见呼吸道病原，感染后肾损伤的主要临床 表现为肾小球肾炎、肾病综合征（NS）及肾小管间质性肾炎和临床症状不明显的肾小球肾炎。A族 溶血性链 β 球菌是儿童急性肾小球肾炎最常见的病因（50% ~90% ）。肺炎支原体感染和呼吸道常见病毒相关性肾损害是 儿童急性非链球菌感染后肾脏疾病的重要组成部分，与链球菌感染后肾炎比较，疾病过程及预后相对较好，血 尿、高血压、血清补体下降程度较轻，且持续时间较短，恢复快，NS患儿的水肿、蛋白尿持续时间较短。病毒感 染诱发的婴幼儿喘息或儿童哮喘和肾损伤之间可能存在相似的遗传学基础和免疫发病机制。 【关键词】 呼吸道感染；肾损伤；儿童 Common respiratory pathogen infection and kidney damage in children LiLing，Guo Yun Department of Respiratory，Children＇s Hospital，Wuxi People＇s Hospital，Nanjing Medical University，Wuxi 214023， JiangsuProvince，China Corresponding author：LiLing，Email：sy333345@1 3.com 【Abstract】 The common respiratory pathogenswhich can cause children kidney disease include bacteria，viru ses，mycoplasma pneumonia，andsoon，themajorclinicalmanifestationsofinfectiousrenalinjuryareglomerularnephri tis，nephrotic syndrome，interstitialnephritisandrenalsubclinicalglomerulonephritis.GroupA -hemolyticstreptococ β cus is the most common cause of acute glomerulonephritis in children（50% -90% ）.Mycoplasma pneumoniae infec tions and respiratory tract virus-associated renal injury arethe important part of kidney disease in childrenwith acute non-streptococcal infection，and comparing withthe streptococcal glomerulonephritis，theprocessandprognosisof my coplasma and virus infection are relatively better，and the level of blood urine，hypertension and serum complement is lower，with shorter duration and rapid recovery，and the duration of edema and proteinuria in children with nephrotic syndrome is shorter a