患有异常性性综合征的儿童需要进行脏活检吗?
Zivile Bekassy1,2, Martin Lindström3, Therese Rosenblad1,2
1Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.
Acta paediatrica (Oslo, Norway : 1992)
|August 29, 2023
概括
在北欧,对于类固醇敏感性脏综合征的儿童,脏活检很少需要. 这项研究建议重新考虑这些患者目前的活检实践.
科学领域:
- 儿科脏病学 儿科脏病学
- 临床研究 临床研究
- 免疫学 免疫学 免疫学
背景情况:
- 类固醇敏感性性综合征 (SSNS) 是儿童常见的病.
- 脏活检是一种具有潜在并发症的侵入性手术.
- 目前关于儿科SSNS脏活检的指导方针和做法各不相同.
研究的目的:
- 评估在北欧环境下SSNS儿童的诊断产量和脏活检的必要性.
- 确定是否可以修改目前在儿科SSNS中进行脏活检的做法.
主要方法:
- 在瑞典南部从1999年到2018年治疗的124名患有异常性性综合征的儿童 (1-18岁) 的回顾性研究.
- 分析临床数据,活检指示,组织学发现和并发症.
- 平均随访时间为6.5年.
主要成果:
- 92%的儿童患有类固醇敏感性疾病.
- 75%的病例进行了脏活检,最常见的是类固醇依赖或复发性疾病 (58.4%).
- 只有1.3%的类固醇敏感儿童的诊断除了微小变化脏病外;6.6%的活检导致出血.
结论:
- 脏活检在没有并发症的异常性脏综合征的类固醇敏感儿童中提供了有限的额外医疗信息.
- 北欧国家对儿科SSNS进行脏活检的做法可能会被重新考虑.
- 减少活检可以提高患者的安全性,降低医疗保健成本.
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