Kabuki N, Okugawa T, Hayakawa H, Tomizawa S, Kasahara T, Uchiyama M
Department of Pediatrics, Niigata University School of Medicine, Niigata City, Niigata Prefecture, Japan.
Pediatr Nephrol. 1998 Aug;12(6):467-70. doi: 10.1007/s004670050489.
To investigate whether age at onset of steroid-sensitive nephrotic syndrome (SSNS) is predictive of subsequent relapses, or influences outcome, we retrospectively studied 60 patients who were under 10 years of age at onset and were followed for over 10 years. They were divided into three groups according to age at diagnosis: group 1-3 (1.0-3.9 years at onset, n=24), group 4-6 (4.0-6.9 years at onset, n=22), and group 7-9 (7.0-9.9 years at onset, n=14). In the 51 patients with long-term remission, defined as remaining relapse-free over 3 years, the total number of relapses was significantly more in group 1-3 (n=18) than in group 4-6 (n=19), and the interval between onset and long-term remission was significantly longer. Group 4-6 and group 7-9 had fewer patients with active disease at 10 years, follow-up than group 1-3, as assessed by the Kaplan-Meier method. These data suggest that the age at onset of SSNS influences the clinical course (i.e., frequency of relapses) and the time to reach long-term remission. An age of less than 4 years at onset of SSNS is associated with greater likelihood for frequent relapses and a greater time interval to attain long-term remission.
为了研究激素敏感型肾病综合征（SSNS）的起病年龄是否可预测随后的复发情况或影响预后，我们回顾性研究了60例起病时年龄小于10岁且随访超过10年的患者。根据诊断时的年龄将他们分为三组：第1 - 3组（起病时1.0 - 3.9岁，n = 24），第4 - 6组（起病时4.0 - 6.9岁，n = 22），以及第7 - 9组（起病时7.0 - 9.9岁，n = 14）。在51例长期缓解（定义为3年以上无复发）的患者中，第1 - 3组（n = 18）的复发总数显著多于第4 - 6组（n = 19），且起病至长期缓解的间隔时间显著更长。通过Kaplan - Meier方法评估，在10年随访时，第4 - 6组和第7 - 9组活动性疾病患者少于第1 - 3组。这些数据表明，SSNS的起病年龄影响临床病程（即复发频率）和达到长期缓解的时间。SSNS起病年龄小于4岁与频繁复发的可能性更大以及达到长期缓解的时间间隔更长有关。
