Zhao Shui-Ai, Ning Bo-Tao, Mao Jian-Hua
Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of PICU, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
World J Pediatr. 2017 Apr;13(2):183-185. doi: 10.1007/s12519-017-0021-x. Epub 2017 Mar 28.
Hemolytic uremic syndrome (HUS) is a main cause of acute renal failure in children. This study aimed to analyze the clinical characteristics of HUS.
A retrospective analysis was performed in 46 children with sporadic HUS.
Of the 46 HUS patients, 20 (43.5%) were diarrhea-related HUS, and 26 (56.5%) were atypical HUS. Anemia, edema, oliguria, hemoglobinuria and hypertension were the most common manifestations. Thrombocytopenia, hyponatremia, hypocalcemia, hyperkalemia, metabolic acidosis, increased fibrinogen and hypocomplementemia were found in most patients. The age of onset (younger than 2 years or not, P=0.009), the duration of oliguria or anuria (more than one week or not, P=0.005), accompanied with extrarenal complications or not (P=0.005), dialysis and plasma exchange (P=0.04) were associated with the mortality rate.
The age of onset younger than 2 years, oliguria/anuria more than 1 week, and associated with extrarenal complications were predictive factors of poor prognosis.
溶血性尿毒症综合征（HUS）是儿童急性肾衰竭的主要原因。本研究旨在分析HUS的临床特征。
对46例散发性HUS患儿进行回顾性分析。
46例HUS患者中，20例（43.5%）为腹泻相关性HUS，26例（56.5%）为非典型HUS。贫血、水肿、少尿、血红蛋白尿和高血压是最常见的表现。大多数患者存在血小板减少、低钠血症、低钙血症、高钾血症、代谢性酸中毒、纤维蛋白原升高和补体降低。发病年龄（是否小于2岁，P=0.009）、少尿或无尿持续时间（是否超过1周，P=0.005）、是否伴有肾外并发症（P=0.005）、透析及血浆置换（P=0.04）与死亡率相关。
发病年龄小于2岁、少尿/无尿超过1周且伴有肾外并发症是预后不良的预测因素。
