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[原发性肾病综合征患儿糖皮质激素所致眼部不良反应的临床特征]

[Clinical characteristics of glucocorticoid-induced eye adverse reactions in children with primary nephrotic syndrome].

作者信息

Zhao Y, Su B G, Xiao H J, Zhang H W, Liu X Y, Wang F, Ding J

机构信息

Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Oct 18;49(5):794-797.

Abstract

OBJECTIVE

To investigate the clinical features and side effects, with regard to glucocorticoid-induced ocular hypertension, glaucoma or cataract in children with primary nephrotic syndrome.

METHODS

Clinical data were collected and analyzed from 71 cases of primary nephrotic syndrome with glucocorticoid-induced ocular hypertension, glaucoma or cataract from Jun. 2014 to Jun. 2016. These children were hospitalized in Peking University First Hospital.

RESULTS

Totally 1 580 children with primary nephrotic syndrome were collected, glucocorticoid-induced complications in eyes were found in 71 cases, and the incidence was 4.5%. There were 66 cases with ocular hypertension, 2 cases with glucocorticoid glaucoma, 2 cases with glucocorticoid glaucoma combined with cataract, 1 case with high intraocular pressure combined with cataract. There were 41 boys and 30 girls with eye-related side effects caused by glucocorticoid. The average age of onset of glucocorticoid-induced eye adverse reactions in children with primary nephrotic syndrome in our research were 8 (2, 16) years. The average duration or interval time from glucocorticoid medication use to eye adverse effects was 157 (6, 420) days. No statistical significance was found in intraocular pressure between different genders, types of glucocorticoid, different route of glucocorticoid and whether methylprednisolone pulse treatment (P>0.05). There was no significant correlation between age, body mass index, blood pressure, cumulative dosage, duration time of glucocorticoid, mean daily dosage and glucocorticoid-induced ocular hypertension (P>0.05). The ocular hypertension was controlled after treatment.

CONCLUSION

Children with nephrotic syndrome after treatment of glucocorticoid are susceptible to ocular complications, and the occurrence of ocular hypertension is closely related to glucocorticoid susceptibility of the nephrotic children. Regular eye monitor is indispensable for the children suffering from primary nephrotic syndrome.

摘要

目的

探讨原发性肾病综合征患儿糖皮质激素性高眼压、青光眼或白内障的临床特征及副作用。

方法

收集并分析2014年6月至2016年6月在北京大学第一医院住院的71例原发性肾病综合征合并糖皮质激素性高眼压、青光眼或白内障患儿的临床资料。

结果

共收集1580例原发性肾病综合征患儿,其中71例出现糖皮质激素引起的眼部并发症,发生率为4.5%。高眼压66例,糖皮质激素性青光眼2例,糖皮质激素性青光眼合并白内障2例,高眼压合并白内障1例。糖皮质激素引起眼部相关副作用的患儿中,男41例,女30例。本研究中原发性肾病综合征患儿糖皮质激素性眼部不良反应的平均发病年龄为8(2,16)岁。从使用糖皮质激素药物到出现眼部不良反应的平均持续时间或间隔时间为157(6,420)天。不同性别、糖皮质激素类型、糖皮质激素给药途径及是否进行甲泼尼龙冲击治疗之间眼压差异无统计学意义(P>0.05)。年龄、体重指数、血压、糖皮质激素累积剂量、使用时间、日均剂量与糖皮质激素性高眼压之间无显著相关性(P>0.05)。治疗后眼压得到控制。

结论

原发性肾病综合征患儿糖皮质激素治疗后易发生眼部并发症,高眼压的发生与肾病患儿对糖皮质激素的易感性密切相关。对于原发性肾病综合征患儿,定期眼部监测必不可少。

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