儿童性综合征中的功能和死亡率
Cal H Robinson1,2,3, Bess-Joan Ogome2, Nithiakishna Selvathesan1,2
1Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada.
概括
患有类固醇敏感性性综合征的儿童患功能衰竭,慢性病 (CKD) 和死亡的风险较低. 然而,患有类固醇耐药性性综合征的儿童面临的风险明显更高,尽管这些比例正在下降.
科学领域:
- 儿科脏病学 儿科脏病学
- 慢性病流行病学 慢性病流行病学
- 儿童脏疾病 儿童脏疾病
背景情况:
- 性综合征是一种普遍存在的儿童病.
- 经常复发,急性损伤和免疫抑制治疗可以发展为慢性病 (CKD).
研究的目的:
- 为了确定衰竭,慢性病,癌症的发病率和患有异常性综合征的儿童的死亡率.
- 为了比较类固醇敏感性和类固醇耐药性性综合征之间的结果.
主要方法:
- 在五个主要数据库 (MEDLINE,EMBASE,CENTRAL,Web of Science,ClinicalTrials.gov) 中从1970年到2024年进行了系统的文献搜索.
- 包括的研究包括患有异常性性综合征的儿童,并报告了功能衰竭,CKD,癌症或死亡的发生率.
- 根据PRISMA指南,进行了元分析来计算结果的发病率 (IR).
主要成果:
- 包括229项涉及32,712名儿童的研究,随访时间中位数为5.1年.
- 对于类固醇敏感性性综合征,每1000人年发生率为:功能衰竭2.65,CKD3.80,死亡率为2.30.
- 对于类固醇耐药性性综合征,每1000人/年的发病率明显高:功能衰竭33.34,CKD46.90,死亡率12.52. 癌症发生率很低 (16例).
结论:
- 患有类固醇敏感性性综合征的儿童患衰竭,慢性病和死亡的发病率较低 (每1000人年<4人).
- 类固醇耐药性性综合征与大量较高的CKD和死亡率有关,尽管这些随着时间的推移而下降.
- 研究的局限性包括中度至高的偏差风险和结果定义和监测的变化.
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