Adhikari M, Manikkam N E, Coovadia H M
Department of Peadiatrics and Child Health, Faculty of Medicine, University of Natal, South Africa.
Pediatr Nephrol. 1992 Jan;6(1):4-9. doi: 10.1007/BF00856818.
The growth-inhibitory effects of courses of daily steroid therapy and of persistent proteinuria were assessed in 125 Indian and African children with nephrotic syndrome (NS) who were followed for an average of 3.9 years (range 0.25-14 years). Among the biopsied patients, 81% of Indians had minimal--change nephropathy and 49% of Africans had membranous nephropathy. The mean height standard deviation score (SDS) in 87 children who had received prednisone for an average of 36 weeks (range 4-250 weeks) was compared with that in 38 patients who had been managed symptomatically. Heights of untreated African children with persistent proteinuria were within the normal range for age, race and sex. The height SDS +/- SD for 77 Indian children in the prednisone-treated group was -1.06 +/- 1.44, which was not significantly different from -0.92 +/- 0.96 observed among 6 children in the untreated group (P = 0.75). In Africans the height SDS in 10 prednisone-treated children was -1.82 +/- 0.81 which was similar to that observed (P = 0.74) in 32 untreated patients -1.77 +/- 1.61. No significant correlation was found between the duration of prednisone therapy and height SDS for individual children among the 87 treated patients using regression analysis. The findings remained unchanged when children who had received less than 12 weeks of prednisone were excluded, or when comparison were drawn between those treated for less than and longer than 36 weeks. We conclude that courses of daily steroids or persistent proteinuria do not inhibit linear growth in Indian and African children with NS.
对125名印度和非洲肾病综合征（NS）患儿进行了每日类固醇治疗疗程和持续性蛋白尿的生长抑制作用评估，这些患儿平均随访3.9年（范围0.25 - 14年）。在接受活检的患者中，81%的印度人患有微小病变性肾病，49%的非洲人患有膜性肾病。将平均接受泼尼松治疗36周（范围4 - 250周）的87名儿童的平均身高标准差评分（SDS）与38名接受对症治疗的患者进行比较。持续性蛋白尿的未治疗非洲儿童的身高在年龄、种族和性别的正常范围内。泼尼松治疗组77名印度儿童的身高SDS±SD为 -1.06±1.44，与未治疗组6名儿童中观察到的 -0.92±0.96无显著差异（P = 0.75）。在非洲人中，10名泼尼松治疗儿童的身高SDS为 -1.82±0.81，与32名未治疗患者中观察到的 -1.77±1.61相似（P = 0.74）。使用回归分析，在87名接受治疗的患者中，未发现泼尼松治疗持续时间与个体儿童身高SDS之间存在显著相关性。当排除接受泼尼松治疗少于12周的儿童，或在治疗少于36周和多于36周的儿童之间进行比较时，结果保持不变。我们得出结论，每日类固醇疗程或持续性蛋白尿不会抑制印度和非洲NS患儿的线性生长。
