Green D A, Murphy W G, Uttley W S
Royal Hospital for Sick Children, Royal Infirmary, Edinburgh, UK.
Clin Lab Haematol. 2000 Feb;22(1):11-4. doi: 10.1046/j.1365-2257.2000.00272.x.
Haemolytic uraemic syndrome (HUS) associated with Escherichia coli O157:H7 is the commonest cause of acute renal failure (ARF) in childhood. Production of verotoxin by the organism is pivotal in the pathogenesis of the disease. Verotoxin binds to a receptor on blood and endothelial cells, expressed as the P1 blood group antigen on red blood cells. A protective effect of the P1 phenotype has been proposed in this disease. This study investigates prognostic factors and the relationship between outcome and P1 phenotype in 27 cases of diarrhoea-associated HUS. A poor outcome as defined by the presence of chronic renal failure (CRF), hypertension or proteinuria on 6 month follow-up was associated with the age of the patient at presentation and with the following clinical markers: maximum WBC and duration of raised WBC, duration of anuria and duration of need for dialysis. None of these outcome measures or prognostic factors, and no extra-renal manifestations of the disease were associated with P1 phenotype.
与大肠杆菌O157:H7相关的溶血性尿毒综合征（HUS）是儿童急性肾衰竭（ARF）最常见的病因。该病原体产生的志贺毒素在疾病的发病机制中起关键作用。志贺毒素与血液和内皮细胞上的一种受体结合，这种受体在红细胞上表现为P1血型抗原。有人提出P1表型在这种疾病中具有保护作用。本研究调查了27例腹泻相关性HUS患者的预后因素以及预后与P1表型之间的关系。随访6个月时，根据是否存在慢性肾衰竭（CRF）、高血压或蛋白尿所定义的不良预后与患者就诊时的年龄以及以下临床指标有关：白细胞计数最高值和白细胞升高持续时间、无尿持续时间以及需要透析的持续时间。这些预后指标或预后因素以及该疾病的肾外表现均与P1表型无关。
