Sureshkumar Premala, Hodson Elisabeth M, Willis Narelle S, Barzi Federica, Craig Jonathan C
Centre for Kidney Research, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW 2145, Australia.
Pediatr Nephrol. 2014 Jun;29(6):1039-46. doi: 10.1007/s00467-013-2736-9. Epub 2014 Feb 2.
Although most children with idiopathic nephrotic syndrome will respond to corticosteroid therapy, 80-90 % suffer one or more relapses.
Using Cox proportional hazard models, we analyzed predictors of remission and relapse in 1-year follow-up data on children aged below 15 years with new-onset nephrotic syndrome.
Of 129 children, 107 achieved remission with corticosteroid therapy and 86 subsequently relapsed. Boys achieved remission more often than girls (adjusted hazard ratio [AHR] 1.52, 95 % confidence interval (CI) 1.02-2.3). Boys relapsed significantly more frequently than girls (AHR 1.77, 95 % CI 1.11-2.83) and were more likely to have frequently relapsing disease (AHR 3.3, 95 % CI 1.18-9.23). The risk of first relapse increased with the number of days to first remission (AHR 1.02, 95 % CI 1.01-1.04). The risk for a frequently relapsing course increased with a shorter time from remission to first relapse (AHR 0.92, 95 % CI 0.87-0.97).
In idiopathic nephrotic syndrome, boys are more likely to respond initially, more likely to relapse, and to be classified as having frequently relapsing nephrotic syndrome. A decrease in time from remission to first relapse predicts for a frequently relapsing course.
尽管大多数特发性肾病综合征患儿对皮质类固醇治疗有反应，但80% - 90%会复发一次或多次。
我们使用Cox比例风险模型，分析了15岁以下新发肾病综合征患儿1年随访数据中的缓解和复发预测因素。
129名儿童中，107名通过皮质类固醇治疗实现缓解，其中86名随后复发。男孩缓解的比例高于女孩（调整后风险比[AHR] 1.52，95%置信区间[CI] 1.02 - 2.3）。男孩复发的频率显著高于女孩（AHR 1.77，95% CI 1.11 - 2.83），且更易患频繁复发性疾病（AHR 3.3，95% CI 1.18 - 9.23）。首次复发的风险随首次缓解天数增加而升高（AHR 1.02，95% CI 1.01 - 1.04）。从缓解到首次复发的时间越短，频繁复发性病程的风险越高（AHR 0.92，95% CI 0.87 - 0.97）。
在特发性肾病综合征中，男孩更易初始缓解、更易复发，且更易被归类为频繁复发性肾病综合征。从缓解到首次复发时间的缩短预示着频繁复发性病程。
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